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NPI Profile for MILES A CLARK in ELK, CA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X |
| NPI Number | 1104399765 |
|
| Status | Active | |
| Credentials | MFT (Marriage and Family Therapist) | |
| Entity | Individual | |
| Enumeration date | 01/07/2019 | |
| Last updated | 01/07/2019 - About 7 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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MILES A CLARK
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MILES A CLARK, MFT