Individual
MRS. ANN MARIE MONICA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3524 ACACIA AVENUE, SAN BERNARDINO, CA 92405
(909) 352-6701
Mailing address
1651 N. RIVERSIDE AVE, #124, RIALTO, CA 92376
(909) 528-7061
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
11/29/2016
Last updated
11/29/2016
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