Individual
STEVEN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7041 20TH AVE, CENTERVILLE, MN 55038-9737
(612) 845-4248
Mailing address
7041 20TH AVE, CENTERVILLE, MN 55038-9737
(612) 845-4248
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
MN
Other
Enumeration date
05/12/2023
Last updated
05/12/2023
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