| NPI | 1811304025 |
|---|---|
| Doing Business As | KAELI A. CLARK |
| Entity Type | Organization |
| Authorized Contact | KAELI A CLARK Owner 206-419-9168 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA 60295090) |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2014-07-21 |