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Individual

JEFF CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
118 E CHOCCOLOCCO ST, OXFORD, AL 36203-1222
(256) 831-4601
Mailing address
208 CARTER ST, MUNFORD, AL 36268-6984
(256) 521-1666

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
06/12/2020
Last updated
06/12/2020
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