Individual
DERRICK ROGERS CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
673 WESTBURY DR STE 201, IOWA CITY, IA 52245-2732
(319) 356-6352
(319) 358-2367
Mailing address
673 WESTBURY DR STE 201, IOWA CITY, IA 52245-2732
(319) 356-6352
(319) 358-2367
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
2010031959
MO
101YM0800X
Mental Health Counselor
Primary
072850
IA
Other
Enumeration date
09/15/2010
Last updated
02/16/2022
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