Individual provider · Type 1 NPI

Tina Marie Clark, FSP

Peer Specialist · Idabel, OK

NPI number 1871000877 Active

Practice location

411 S Central Ave
Idabel, OK 74745-6059

Call (580) 286-5045 Map

Fax (580) 286-5721

Mailing address

PO Box 1030
Antlers, OK 74523-1030

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist Primary 175T00000XNone listed

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1871000877

Tina Marie Clark, FSP's National Provider Identifier is 1871000877, issued on Dec 29, 2017. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Idabel, OK. The record was last updated on Dec 29, 2017.