Individual
MR. CHRISTOPHER TAD CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED.
Contact information
Practice address
1471 DEWAR DR STE 204, ROCK SPRINGS, WY 82901-5826
(307) 630-3466
(307) 316-0228
Mailing address
4000 DEWAR DR, ROCK SPRINGS, WY 82901-6218
(307) 382-3010
(307) 382-6881
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC-1198
WY
101YP2500X
Professional Counselor
Primary
1198
WY
Other
Enumeration date
08/15/2012
Last updated
04/28/2020
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