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1356980122
SHANNEN CLARK
LIVERPOOL, NY
NPI
1356980122
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2019-12-27
Last Update Date
2020-12-22
Business Address
SHANNEN CLARK Counselor
526 OLD LIVERPOOL RD STE 9
LIVERPOOL, NY 13088-6285
Phone number: 315-453-3911
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Mailing Address
SHANNEN CLARK Counselor
147 CUMBERLAND AVE
SYRACUSE, NY 13210-2211
Phone number:
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