TIMOTHY CLARK

FARGO, ND
NPI1831576271
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: ND  1744)
Enumeration Date2015-05-06
Last Update Date2015-05-06
Business Address
TIMOTHY CLARK
4215 9TH AVE S
FARGO, ND 58103-2018
Phone number: 701-478-9554
Mailing Address
TIMOTHY CLARK
4215 9TH AVE S
FARGO, ND 58103-2018
Phone number: 701-478-9554
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