KELLY CLARK

GRESHAM, OR
NPI1861796641
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2011-01-07
Last Update Date2011-01-07
Business Address
-- KELLY CLARK BS, CADC I
400 NE 7TH ST
GRESHAM, OR 97030-5604
Phone number: 503-661-5455
Mailing Address
-- KELLY CLARK BS, CADC I
400 NE 7TH ST
GRESHAM, OR 97030-5604
Phone number: 503-661-5455