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Tina Michelle Clark
Mental Health Counselor in Chehalis, Washington
NPI 1104030899

Tina Michelle Clark is a Mental Health Counselor based in Winlock, WA and is specialized in Mental Health. Tina Michelle Clark practices in Chehalis, WA. The NPI Number for Tina Michelle Clark is 1104030899 and holds a License No. RC00049995 (Washington).

The current practice location address for Tina Michelle Clark is 135 W Main St, Chehalis, WA and can be reached out via phone at 360-748-6696.

Location: 135 W Main St, Chehalis, WA, 98596-9330
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1104030899
Provider Name
Tina Michelle Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
135 W Main St, Chehalis, WA, 98596-9330
Phone Number
360-748-6696
Fax Number
Provider Enumeration Date
05/10/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
135 W Main St
City
Chehalis
State
Washington
Zip
98532-4817
Phone Number
360-748-6696
Fax Number
person
Provider Business Mailing Address Details
Address
135 W Main St
City
Chehalis
State
Washington
Zip
98532-4817
Phone Number
360-748-6696
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
RC00049995 (Washington)
Definition
Definition to come...
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