Individual provider · Type 1 NPI
Terry James Clark, CSC-AD
Addiction (Substance Use Disorder) Counselor · Baltimore, MD
NPI number
1861688053
Active
Practice location
111 Park Ave
Baltimore, MD 21201-3402
Fax (410) 837-2168
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | SC0551 (MD) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1861688053
Terry James Clark, CSC-AD's National Provider Identifier is 1861688053, issued on Sep 20, 2007. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Baltimore, MD. The record was last updated on Sep 20, 2007.