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1760500623
LINCOLIN HENRY CLARK
DETROIT, MI
NPI
1760500623
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-03-27
Last Update Date
2007-07-26
Business Address
Mr. LINCOLIN HENRY CLARK FAODP
514 ALGER ST
DETROIT, MI 48202-2106
Phone number: 313-871-9940
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Mailing Address
Mr. LINCOLIN HENRY CLARK FAODP
925 WHITMORE RD APT A1
DETROIT, MI 48203-1749
Phone number: 313-399-3727
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