Individual
MS. KENDELL ELAINE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC, NCC
Contact information
Practice address
1118 NORTH 13TH STREET, FREDERICK, OK 73542-1605
(580) 335-4860
Mailing address
400 SUNNYBROOK DR, FREDERICK, OK 73542-4013
(580) 335-4860
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/23/2011
Last updated
07/17/2024
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