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1508061615
ELIZABETH CLARK
SAN BERNARDINO, CA
NPI
1508061615
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 01-047276)
Enumeration Date
2007-06-19
Last Update Date
2014-06-16
Business Address
-- ELIZABETH CLARK
780 E GILBERT ST SUITE 23 & 24
SAN BERNARDINO, CA 92415-1003
Phone number: 909-387-7458
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Mailing Address
-- ELIZABETH CLARK
4369 SIERRA AVE
NORCO, CA 92860-1347
Phone number: 909-387-7458
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