person
Florence Tacy Clark
Addiction (Substance Use Disorder) Counselor in Antioch, California
NPI 1386857670

Florence Tacy Clark is an Addiction (Substance Use Disorder) Counselor based in Antioch, CA and is specialized in Addiction (Substance Use Disorder). Florence Tacy Clark practices in Antioch, CA. The NPI Number for Florence Tacy Clark is 1386857670 and holds a License No. (California).

The current practice location address for Florence Tacy Clark is 1915 D St, Antioch, CA and can be reached out via phone at 925-754-3673 and via fax at 925-754-2002. You can also correspond with Florence Tacy Clark through the mailing address at 1915 D ST, ANTIOCH, CA - 94509-2571 (mailing address contact number: 925-754-3673).

Location: 1915 D St, Antioch, CA, 94509-2571
person
Provider Profile Details
NPI Number
1386857670
Provider Name
Florence Tacy Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
1915 D St, Antioch, CA, 94509-2571
Phone Number
925-754-3673
Fax Number
925-754-2002
Provider Enumeration Date
05/07/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
07553 01 CA BRENTWOOD ADOL TX
07533 01 CA ADOL TX - ANTIOCH
07536 01 CA DMC ADOL ANTIOCH
07552 01 CA DMC ADULT BRENTWOOD
07556 01 CA BYRON RANCH
070753 01 CA MASTER PROVIDER NUMBER
0753 01 CA DRUG MEDI-CAL BILLING NUM
07531 01 CA ADULT TX - ANTIOCH
07551 01 CA ADULT TX - BWD
070726 01 CA MASTER PROVIDER NUMBER
0726 01 CA DRUG M/CAL BILLING NUMBER
07534 01 CA DMC ADULT ANTIOCH
07555 01 CA DRUG CT
07557 01 CA DMC ADOL BRENTWOOD
56678 01 CA STAFF ID NUMBER
institution
Provider Business Practice Location Address Details
Address
1915 D St
City
State
Zip
94509-2571
Phone Number
925-754-3673
Fax Number
925-754-2002
person
Provider Business Mailing Address Details
Address
1915 D St
City
State
Zip
94509-2571
Phone Number
925-754-3673
Fax Number
925-754-2002
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
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Definition
Definition to come...
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