Individual
DR. PATRICIA ANN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LPC
Contact information
Practice address
112 S. MADISON, AURORA, MO 65605
(866) 678-6233
Mailing address
2227 E CARDINAL ST, SPRINGFIELD, MO 65804-6757
(417) 343-3612
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2004035218
MO
Other
Enumeration date
11/14/2006
Last updated
07/08/2007
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