Individual
ALLISON M CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1655 SW HIGHLAND AVE STE 3, REDMOND, OR 97756-2558
(541) 923-2654
Mailing address
20683 LIBERTY LN, BEND, OR 97701-8564
(503) 812-7040
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500617421
—
OR
Enumeration date
07/10/2017
Last updated
06/16/2018
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