Individual
INDIA LARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
604 FERN AVE, MAGNOLIA, NJ 08049-1218
(856) 562-8916
Mailing address
604 FERN AVE, MAGNOLIA, NJ 08049-1218
(856) 562-8916
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
374J00000X
Doula
—
—
Other
Enumeration date
10/16/2021
Last updated
08/20/2024
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