Individual
SHANNON CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
235 W LANCASTER AVE, DEVON, PA 19333-1560
(484) 551-3366
Mailing address
1935 MATHER WAY # A, ELKINS PARK, PA 19027-1022
(215) 391-5558
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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