Individual
STEPHANIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23821 ROYALTON RD, COLUMBIA STATION, OH 44028-9458
(440) 667-6704
Mailing address
23821 ROYALTON RD, COLUMBIA STATION, OH 44028-9458
(440) 667-6704
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/27/2024
Last updated
05/27/2024
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