Individual
MISS CAITLIN ALEXANDRA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, CADC I
Contact information
Practice address
149 W 12TH AVE, EUGENE, OR 97401-6215
(541) 484-9274
(541) 484-5021
Mailing address
1199 N TERRY ST, 180, EUGENE, OR 97402-1459
(541) 968-4282
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/24/2012
Last updated
10/30/2012
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