Individual provider · Type 1 NPI

Tina Michelle Clark

Mental Health Counselor · Chehalis, WA

NPI number 1104030899 Active

Practice location

135 W Main St
Chehalis, WA 98532-4817

Mailing address

1313 Ferrier Rd
Winlock, WA 98596-9330

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XRC00049995 (WA)

Mental Health Counselor: Definition to come...

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About NPI 1104030899

Tina Michelle Clark's National Provider Identifier is 1104030899, issued on May 10, 2007. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Chehalis, WA. The record was last updated on Jul 8, 2007.