Individual
MRS. SHELLY RENE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3940 CORNHUSKER HWY, LINCOLN, NE 68504-1534
(402) 464-8866
Mailing address
1540 JANSSEN DR, LINCOLN, NE 68506-1842
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7653
NE
Other
Enumeration date
11/28/2006
Last updated
07/08/2007
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