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1134631260
SAMUEL REESE CLARK
ORANGE, CA
NPI
1134631260
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2017-10-30
Last Update Date
2017-10-30
Business Address
SAMUEL REESE CLARK
705 W LA VETA AVE STE 208
ORANGE, CA 92868-4448
Phone number: 714-532-9295
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Mailing Address
SAMUEL REESE CLARK
20542 TOBERMORY CIR
HUNTINGTON BEACH, CA 92646-5837
Phone number: 925-278-8100
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