Individual provider · Type 1 NPI
Latarious Clark
Professional Counselor · Athens, GA
NPI number
1659827673
Active
Practice location
135 Brentwood Dr
Athens, GA 30605-3901
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | LPC009108 (GA) |
Professional Counselor: Definition to come...
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About NPI 1659827673
Latarious Clark's National Provider Identifier is 1659827673, issued on Aug 30, 2016. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Athens, GA. The record was last updated on Aug 30, 2016.