Individual
MS. JAN CHRISTINE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TLMHC
Contact information
Practice address
509 AVENUE F, FORT MADISON, IA 52627-2910
(319) 372-3566
(319) 372-8074
Mailing address
301 W BURLINGTON AVE, FAIRFIELD, IA 52556-3242
(641) 472-1864
(641) 472-4609
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
123568
IA
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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