Individual
MR. LANCE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LCMHC, BCTMH, QS
Contact information
Practice address
320 N JUDD PKWY NE STE 226, FUQUAY VARINA, NC 27526-2624
(919) 812-7535
Mailing address
320 N JUDD PKWY NE STE 226, FUQUAY VARINA, NC 27526-2624
(919) 812-7535
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
9217
NC
Other
Enumeration date
01/20/2012
Last updated
06/09/2022
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