Individual
MARIA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LIMPH
Contact information
Practice address
1620 WILSHIRE DR STE 222, BELLEVUE, NE 68005
(402) 536-9568
Mailing address
2613 BLACKHAWK DR, BELLEVUE, NE 68123-3707
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1579
NE
101YP2500X
Professional Counselor
Primary
1579
NE
Other
Enumeration date
04/06/2017
Last updated
07/26/2018
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