Individual
KIMBERLY NICOLE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4202 SW LEE BLVD, LAWTON, OK 73505-8300
(575) 642-3673
Mailing address
85 QUAIL CREEK DR, LAWTON, OK 73507-9026
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
OK
Other
Enumeration date
08/29/2018
Last updated
07/20/2020
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