Individual
ELEANOR ANN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC-A
Contact information
Practice address
2816 CANTERBURY LN, INDIANAPOLIS, IN 46220-2243
(812) 345-8928
Mailing address
2816 CANTERBURY LN, INDIANAPOLIS, IN 46220-2243
(812) 345-8928
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
88001320A
IN
Other
Enumeration date
10/29/2021
Last updated
10/29/2021
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