Individual
MR. STEVEN W. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAMF, COAMF, CDVF
Contact information
Practice address
3300 BASS LAKE ROAD, SUITE 314, BROOKLYN CENTER, MN 55429
(763) 913-0130
Mailing address
8812 YATES TERRACE NORTH, BROOKLYN PARK, MN 55443
(763) 913-0130
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/06/2011
Last updated
10/06/2011
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