Autumn L Clark, BA
Counselor in Spokane, WA. Individual provider (NPI-1).
NPI number1669947016
StatusActive
Last updated in NPPESDec 4, 2018
Details
- NPI
- 1669947016
- Entity type
- Individual (NPI-1)
- Name
- Autumn L Clark
- Credential
- BA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 11, 2018
- Last updated
- Dec 4, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101Y00000X | Counselor | CG60902893 | WA | Yes |
Practice location
5125 N Market StSpokane, WA 99217-6131
Phone 509-838-4651
Mailing address
107 S Division StSpokane, WA 99202-1510
Phone 509-838-4651 · Fax 509-363-2762
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