Individual
MR. ROBERT BICKNELL CLARK III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADC-1
Contact information
Practice address
4200 NORTHSIDE PKWY NW BLDG 7, ATLANTA, GA 30327-3007
(404) 793-6349
Mailing address
4200 NORTHSIDE PKWY NW BLDG 7, ATLANTA, GA 30327-3007
(404) 793-6349
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0689
GA
Other
Enumeration date
07/23/2021
Last updated
07/23/2021
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