| NPI | 1740466382 |
|---|---|
| Former Name | CYNTHIA LOUISE CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.1800544) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional (Licence: OR C4404) | |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2021-09-20 |