| NPI | 1528718905 |
|---|---|
| Former Name | AMINDA LEE CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801119229) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-05215) |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2025-05-06 |