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1215303995
MICHELE C CLARK
BLOOMINGTON, CA
NPI
1215303995
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-08-17
Last Update Date
2018-03-08
Business Address
MICHELE C CLARK CADC-I
18612 SANTA ANA AVE
BLOOMINGTON, CA 92316-2636
Phone number: 909-421-7120
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Mailing Address
MICHELE C CLARK CADC-I
940 AVENUE 64
PASADENA, CA 91105-2711
Phone number: 323-254-2274
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