Individual
ANNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
1115 N SHOOP AVE STE 1, WAUSEON, OH 43567-1857
(419) 335-6122
(419) 318-4157
Mailing address
1115 N SHOOP AVE STE 1, WAUSEON, OH 43567-1857
(419) 335-6122
(419) 318-4157
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
031136
OH
101YM0800X
Mental Health Counselor
Primary
E4140
OH
Other
Enumeration date
08/05/2007
Last updated
04/02/2015
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