Individual
COLLIN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 AUSTIN ST, EVANSTON, IL 60202-3439
(847) 868-8664
Mailing address
800 AUSTIN ST # 312, EVANSTON, IL 60202-3439
(847) 868-8664
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
12/16/2024
Last updated
12/16/2024
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