Individual
ANDREA MARIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 W 4TH ST, ANTIOCH, CA 94509-1024
(925) 778-3750
(925) 778-3750
Mailing address
1401 W 4TH ST, ANTIOCH, CA 94509-1024
(925) 778-3750
(925) 778-3750
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/30/2008
Last updated
03/17/2009
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