Kelly Clark, BS, CADC I
Counselor, Addiction (Substance Use Disorder) in Gresham, OR. Individual provider (NPI-1).
NPI number1861796641
StatusActive
Last updated in NPPESJan 7, 2011
Details
- NPI
- 1861796641
- Entity type
- Individual (NPI-1)
- Name
- Kelly Clark
- Credential
- BS, CADC I
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 7, 2011
- Last updated
- Jan 7, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – | Yes |
Practice location
400 Ne 7th StGresham, OR 97030-5604
Phone 503-661-5455 · Fax 503-661-4959
Mailing address
400 Ne 7th StGresham, OR 97030-5604
Phone 503-661-5455 · Fax 503-661-4959
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All 87 Addiction (Substance Use Disorder) Counselor providers in Gresham · All 2,430 providers in Gresham
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