Individual
CHARITY ANN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 S RIDGEWOOD AVE, SOUTH DAYTONA, FL 32119-3097
(386) 304-7600
Mailing address
2066 OAK MEADOW CIR, SOUTH DAYTONA, FL 32119-8821
(207) 570-2552
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/21/2016
Last updated
11/21/2016
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