Individual provider · Type 1 NPI
Brenda Gayle Clark
Addiction (Substance Use Disorder) Counselor · Wagoner, OK
NPI number
1467679175
Active
Practice location
109 S. Harrill
Wagoner, OK 74467-5317
Fax (918) 485-8371
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | None listed |
Addiction (Substance Use Disorder) Counselor: Definition to come...
Another provider at this address
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- Shawn WallAddiction (Substance Use Disorder) Counselor Wagoner, OK NPI 1649691908
- Melissa Ann McDaris, BAAddiction (Substance Use Disorder) Counselor Wagoner, OK NPI 1700915337
- Jonathan David PierceAddiction (Substance Use Disorder) Counselor Wagoner, OK NPI 1740433358
About NPI 1467679175
Brenda Gayle Clark's National Provider Identifier is 1467679175, issued on Apr 20, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Wagoner, OK. The record was last updated on Jul 8, 2007.