Individual provider · Type 1 NPI

Evans Clark

Mental Health Counselor · Mattoon, IL

NPI number 1477057727 Active

Practice location

750 Broadway Ave E
Mattoon, IL 61938-4610

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1477057727

Evans Clark's National Provider Identifier is 1477057727, issued on Mar 21, 2018. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Mattoon, IL. The record was last updated on Mar 21, 2018.