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Individual

JACOB CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1416 W EASTERDAY AVE, SAULT SAINTE MARIE, MI 49783-1415
(906) 632-9809
(906) 632-9845
Mailing address
100 MALTON RD, NEGAUNEE, MI 49866-2001
(906) 228-9699

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
01/27/2025
Last updated
01/27/2025
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