Individual
MS. ALICE M CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, CACIII
Contact information
Practice address
5377 MANHATTAN CIR, SUITE 200, BOULDER, CO 80303-4333
(303) 263-7855
Mailing address
1786 YAUPON AVE, BOULDER, CO 80304-4364
(303) 263-7855
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
5499
CO
101YP2500X
Professional Counselor
Primary
1687
CO
Other
Enumeration date
08/14/2006
Last updated
03/21/2011
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