Individual
SHEMIKA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4951 CENTRAL AVE, MONROE, LA 71203
(318) 340-1535
Mailing address
850 KALISTE SALOOM RD, LAFAYETTE, LA 70508-4230
(337) 234-7109
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
11/28/2016
Last updated
10/07/2019
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