Individual
MS. ALETHA JENNIFER CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LPC
Contact information
Practice address
2386 CLOWER ST STE D-100, SNELLVILLE, GA 30078-6134
(404) 550-0564
(678) 344-2956
Mailing address
PO BOX 955, SNELLVILLE, GA 30078-0955
(404) 550-0564
(678) 344-2956
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1658-R
GA
101YP2500X
Professional Counselor
Primary
LPC004805
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
894502453A
—
GA
Enumeration date
02/12/2007
Last updated
02/06/2024
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