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1861628380
STACY CLARK
CHESAPEAKE, VA
NPI
1861628380
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Additional Taxonomies
101Y00000X Counselor
Enumeration Date
2009-06-10
Last Update Date
2009-06-10
Business Address
Mr. STACY CLARK M. Ed
2156 SEASTONE TRCE
CHESAPEAKE, VA 23321-3777
Phone number: 757-803-5261
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Mailing Address
Mr. STACY CLARK M. Ed
2156 SEASTONE TRCE
CHESAPEAKE, VA 23321-3777
Phone number: 757-405-6015
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