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1730546656
ERICA CLARK
SHREVEPORT, LA
NPI
1730546656
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2016-01-22
Last Update Date
2016-01-22
Business Address
-- ERICA CLARK
2209 ROOSEVELT AVE
SHREVEPORT, LA 71104-2773
Phone number: 318-219-6224
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Mailing Address
-- ERICA CLARK
2209 ROOSEVELT AVE
SHREVEPORT, LA 71104-2773
Phone number: 318-219-6224
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