EDWARD DERBY CLARK

SACRAMENTO, CA
NPI1093028870
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2010-07-21
Last Update Date2015-06-18
Business Address
Mr. EDWARD DERBY CLARK
1355 PEBBLEWOOD DR
SACRAMENTO, CA 95833-1612
Phone number: 916-289-9380
Mailing Address
Mr. EDWARD DERBY CLARK
1355 PEBBLEWOOD DR
SACRAMENTO, CA 95833-1612
Phone number: 916-289-9380
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