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1952680324
LISA S CLARK
MELBOURNE, FL
NPI
1952680324
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2011-08-16
Last Update Date
2021-05-27
Business Address
LISA S CLARK
1301 W EAU GALLIE BLVD SUITE 96
MELBOURNE, FL 32935
Phone number: 321-421-6992
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Mailing Address
LISA S CLARK
1223 MEADOW LAKE RD
ROCKLEDGE, FL 32955-8403
Phone number: 321-750-4483
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