person
Gregory Scott Clark JR.
Professional Counselor in Tyler, Texas
NPI 1881055911

Gregory Scott Clark JR. is a Professional Counselor based in Tyler, TX and is specialized in Professional. Gregory Scott Clark JR. practices in Tyler, TX. The NPI Number for Gregory Scott Clark JR. is 1881055911 and holds a License No. 31769 (Texas).

The current practice location address for Gregory Scott Clark JR. is 1121 E Southeast Loop 323 Ste 204, Tyler, TX and can be reached out via phone at 903-581-0933 and via fax at 903-581-0933.

Location: 1121 E Southeast Loop 323 Ste 204, Tyler, TX, 75701-9660
person
Provider Profile Details
NPI Number
1881055911
Provider Name
Gregory Scott Clark JR.
Credential
Provider Entity Type
Individual
Gender
Male
Address
1121 E Southeast Loop 323 Ste 204, Tyler, TX, 75701-9660
Phone Number
903-581-0933
Fax Number
903-581-0933
Provider Enumeration Date
03/17/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1121 E Southeast Loop 323 Ste 204
City
State
Zip
75701
Phone Number
903-581-0933
Fax Number
903-581-0933
person
Provider Business Mailing Address Details
Address
1121 E Southeast Loop 323 Ste 204
City
State
Zip
75701
Phone Number
903-581-0933
Fax Number
903-581-0933
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
78242 (Texas)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
31769 (Texas)
Definition
Definition to come...
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