Individual
STEPHANIE M. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
202 E ROBERT ST, HAMMOND, LA 70401-3350
(985) 543-4070
(985) 543-4073
Mailing address
202 E ROBERT ST, HAMMOND, LA 70401-3350
(985) 543-4070
(985) 543-4073
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
797
LA
Other
Enumeration date
08/01/2006
Last updated
07/08/2007
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