Individual
ANNAMARIA VENCENZA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2520 SAND MINE RD, DAVENPORT, FL 33897-3402
(407) 891-3054
Mailing address
225 MICCO AVE, SEBRING, FL 33870-7031
(863) 446-1019
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/22/2018
Last updated
12/22/2018
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