Individual provider · Type 1 NPI

Sandra Louise Clark, NCACII, LADC, CCJP

Addiction (Substance Use Disorder) Counselor · St. Paul, MN

NPI number 1306015284 Active

Practice location

1885 University Ave W, Suite 20
St. Paul, MN 55104-3489

Fax (763) 767-3145

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X301712 (MN)

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

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About NPI 1306015284

Sandra Louise Clark, NCACII, LADC, CCJP's National Provider Identifier is 1306015284, issued on Feb 26, 2008. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in St. Paul, MN. The record was last updated on Feb 26, 2008.