Skyler Clark
Counselor, Professional in Statesboro, GA. Individual provider (NPI-1).
NPI number1104545342
StatusActive
Last updated in NPPESAug 23, 2022
Details
- NPI
- 1104545342
- Entity type
- Individual (NPI-1)
- Name
- Skyler Clark
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 23, 2022
- Certification date
- Aug 23, 2022
- Last updated
- Aug 23, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | LPC013107 | GA | Yes |
Practice location
27 S Main StStatesboro, GA 30458-5245
Phone 912-225-3769
Mailing address
Po Box 1242Statesboro, GA 30459-1242
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