Individual
MRS. THERESA MARIE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, RPT, NCC
Contact information
Practice address
108 E 12TH ST, SUITE 1, HAYS, KS 67601-3668
(785) 259-5576
Mailing address
PO BOX 1376, HAYS, KS 67601-8376
(785) 259-5576
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC 916
KS
Other
Enumeration date
07/02/2007
Last updated
07/08/2007
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