Kristie Ann Clark, LPC
Counselor, Professional in Saginaw, MI. Individual provider (NPI-1).
NPI number1376928366
StatusActive
Last updated in NPPESApr 15, 2021
Details
- NPI
- 1376928366
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Kristie Ann Clark
- Credential
- LPC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 20, 2015
- Certification date
- Apr 15, 2021
- Last updated
- Apr 15, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 6401011076 | MI | Yes |
Practice location
5090 State StSuite 102-B
Saginaw, MI 48603-7706
Phone 479-685-7830
Mailing address
5090 State StSuite 102-B
Saginaw, MI 48603-7706
Phone 479-685-7830
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