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1215479415
TRACEY CLARK
PUEBLO, CO
NPI
1215479415
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: CO LPC.0016209)
Enumeration Date
2016-11-06
Last Update Date
2022-07-01
Business Address
TRACEY CLARK LPC
300 COLORADO AVE
PUEBLO, CO 81004-2006
Phone number: 719-543-8711
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Mailing Address
TRACEY CLARK LPC
110 E ROUTT AVE
PUEBLO, CO 81004-2117
Phone number: 719-543-8711
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