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1194026013
SHEREESE CLARK
WAUKESHA, WI
NPI
1194026013
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI 16003-130)
Enumeration Date
2010-11-09
Last Update Date
2010-11-09
Business Address
-- SHEREESE CLARK SAC-IT
2422 N GRANDVIEW BLVD
WAUKESHA, WI 53188-6105
Phone number: 262-549-6600
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Mailing Address
-- SHEREESE CLARK SAC-IT
1610 MILLER PARK WAY
MILWAUKEE, WI 53214-3604
Phone number: 262-549-6600
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