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Walter Otha Clark III, CATCII
Addiction (Substance Use Disorder) Counselor in Riverside, California
NPI 1811230980

Walter Otha Clark III is an Addiction (Substance Use Disorder) Counselor based in Riverside, CA and is specialized in Addiction (Substance Use Disorder). Walter Otha Clark III practices in Riverside, CA and has the professional credentials of CATCII. The NPI Number for Walter Otha Clark III is 1811230980 and holds a License No. 3051-I (California).

The current practice location address for Walter Otha Clark III is 3525 Presley Ave, Riverside, CA and can be reached out via phone at 951-782-2400.

Location: 3525 Presley Ave, Riverside, CA, 92507-4453
person
Provider Profile Details
NPI Number
1811230980
Provider Name
Walter Otha Clark III
Credential
CATCII
Provider Entity Type
Individual
Gender
Male
Address
3525 Presley Ave, Riverside, CA, 92507-4453
Phone Number
951-782-2400
Fax Number
Provider Enumeration Date
03/27/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
133051 II 01 CA CAADE
institution
Provider Business Practice Location Address Details
Address
3525 Presley Ave
City
State
Zip
92507-4453
Phone Number
951-782-2400
Fax Number
person
Provider Business Mailing Address Details
Address
3525 Presley Ave
City
State
Zip
92507-4453
Phone Number
951-782-2400
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
133051 II (California)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
3051-I (California)
Definition
Definition to come...
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