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Tina Marie Clark, FSP
Peer Specialist in Idabel, Oklahoma
NPI 1871000877

Tina Marie Clark is a Peer Specialist based in Antlers, OK. Tina Marie Clark practices in Idabel, OK and has the professional credentials of FSP. The NPI Number for Tina Marie Clark is 1871000877 and holds a License No. (Oklahoma).

The current practice location address for Tina Marie Clark is 411 S Central Ave, Idabel, OK and can be reached out via phone at 580-286-5045 and via fax at 580-286-5721.

Location: 411 S Central Ave, Idabel, OK, 74523-1030
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871000877
Provider Name
Tina Marie Clark
Credential
FSP
Provider Entity Type
Individual
Gender
Female
Address
411 S Central Ave, Idabel, OK, 74523-1030
Phone Number
580-286-5045
Fax Number
580-286-5721
Provider Enumeration Date
12/29/2017
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
411 S Central Ave
City
Idabel
State
Oklahoma
Zip
74745-6059
Phone Number
580-286-5045
Fax Number
580-286-5721
person
Provider Business Mailing Address Details
Address
411 S Central Ave
City
Idabel
State
Oklahoma
Zip
74745-6059
Phone Number
580-286-5045
Fax Number
580-286-5721
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
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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