Individual
MARIA G CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LISAC
Contact information
Practice address
3260 N HAYDEN RD, SUITE 112, SCOTTSDALE, AZ 85251-6649
(480) 804-0326
(480) 804-0083
Mailing address
1400 E SOUTHERN AVE, STE. 735, TEMPE, AZ 85282-5691
(480) 804-0326
(480) 302-7884
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LISAC-10628
AZ
101YP2500X
Professional Counselor
Primary
LPC-13317
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
559377
—
AZ
Enumeration date
12/13/2006
Last updated
10/13/2015
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