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1417496829
KEVIN LEE CLARK
SOUTHERN PINES, NC
NPI
1417496829
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: NC LCAS-30345)
Enumeration Date
2017-02-17
Last Update Date
2025-06-25
Business Address
Mr. KEVIN LEE CLARK LCAS-A
150 BOILING SPRINGS CIR
SOUTHERN PINES, NC 28387-3306
Phone number: 910-690-2803
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Mailing Address
Mr. KEVIN LEE CLARK LCAS-A
150 BOILING SPRINGS CIR
SOUTHERN PINES, NC 28387-3306
Phone number: 910-690-2803
Copy
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