Individual
MS. LADONNA M CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCAS
Contact information
Practice address
2949 NEW BERN AVE, SUITE 109, RALEIGH, NC 27610-1248
(919) 212-8156
(919) 212-8158
Mailing address
2949 NEW BERN AVE, SUITE 109, RALEIGH, NC 27610-1248
(919) 212-8156
(919) 212-8158
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1216
NC
106S00000X
Behavior Technician
RBT-19-92952
—
Other
Enumeration date
01/09/2008
Last updated
07/29/2019
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