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1952015141
JEROD CLARK
CLEVELAND, OK
NPI
1952015141
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2023-01-11
Last Update Date
2023-01-11
Business Address
JEROD CLARK
907 W CADDO ST
CLEVELAND, OK 74020-4201
Phone number: 918-607-5576
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Mailing Address
JEROD CLARK
907 W CADDO ST
CLEVELAND, OK 74020-4201
Phone number: 918-607-5576
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