Individual
TERRY JAMES CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSC-AD
Contact information
Practice address
111 PARK AVE, BALTIMORE, MD 21201-3402
(410) 837-5533
(410) 837-2168
Mailing address
111 PARK AVE, BALTIMORE, MD 21201-3402
(410) 837-5533
(410) 837-2168
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
SC0551
MD
Other
Enumeration date
09/20/2007
Last updated
09/20/2007
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