Individual
DAN CLARKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
703 W PATTEN ST, MINEOLA, TX 75773-1541
(903) 569-5409
Mailing address
PO BOX 4730, TYLER, TX 75712-4730
(903) 569-5409
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
12420
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027104102
—
TX
Enumeration date
03/01/2006
Last updated
06/28/2011
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