Individual
RALPH O CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT, LPCA
Contact information
Practice address
2525 RAEFORD RD, SUITE B, FAYETTEVILLE, NC 28305-5091
(757) 814-8922
Mailing address
5905 MAIDSTONE LN, APT A, HOPE MILLS, NC 28348-2760
(757) 814-8922
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
A10090
NC
106H00000X
Marriage & Family Therapist
Primary
1551
NC
Other
Enumeration date
03/02/2013
Last updated
12/22/2015
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