Individual
REBECCA DAWN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APCC
Contact information
Practice address
2180 JOHNSON AVE, SAN LUIS OBISPO, CA 93401-4558
(805) 461-6060
(805) 461-6061
Mailing address
28 MOCKINGBIRD LN, TEMPLETON, CA 93465-9810
(808) 651-1601
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
17202
CA
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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