Individual
MICAH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PLPC
Contact information
Practice address
1759 E ELM ST, SPRINGFIELD, MO 65802-3227
(417) 719-1440
(417) 216-6769
Mailing address
1759 E ELM ST, SPRINGFIELD, MO 65802-3227
(417) 719-1440
(417) 216-6769
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
MO
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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