Individual
JUDITH ANN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPS, EDS.
Contact information
Practice address
244 JEFFERSON ST, LEXINGTON, KY 40508-1217
(859) 233-2225
(859) 233-9498
Mailing address
244 JEFFERSON ST, LEXINGTON, KY 40508-1217
(859) 233-2225
(859) 233-9498
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
F854398
MI
101YM0800X
Mental Health Counselor
Primary
F854398
MI
Other
Enumeration date
04/06/2010
Last updated
04/06/2010
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