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1255799797
TONJA CHARLOTTE CLARK
SHREVEPORT, LA
NPI
1255799797
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
101Y00000X Counselor
Enumeration Date
2016-01-28
Last Update Date
2018-06-05
Business Address
TONJA CHARLOTTE CLARK
2525 YOUREE DR STE 110
SHREVEPORT, LA 71104
Phone number: 318-425-9030
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Mailing Address
TONJA CHARLOTTE CLARK
2525 YOUREE DR STE 110
SHREVEPORT, LA 71104-3600
Phone number: 318-425-9030
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