Individual provider · Type 1 NPI

Sydney Clark

Addiction (Substance Use Disorder) Counselor · Grand Ronde, OR

NPI number 1093410060 Active

Practice location

9615 Grand Ronde Rd
Grand Ronde, OR 97347-9712

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist 175T00000X108162 (OR)
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XT-23-2489 (OR)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1093410060

Sydney Clark's National Provider Identifier is 1093410060, issued on Mar 31, 2023. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Grand Ronde, OR. The record was last updated on Jul 24, 2024.