Individual
MR. ROBERT LUCIEN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.P.C., N.C.C.
Contact information
Practice address
42 NORTH AVENUE, CLEVELAND, GA 30528-1398
(706) 348-8674
(706) 348-8676
Mailing address
19 LAKE PT, SAUTEE NACOOCHEE, GA 30571-5180
(706) 878-1485
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2168
GA
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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