Clark Hislop, SUDPT
Clark Hislop, SUDPT is a Counselor in Longview, Washington. Licensed in Washington. Registered with an NPI since 2024.
- Licensed in
- WA
- In the registry since
- 2024
Practice location Address checks out
748 14th AveLongview, WA 98632-2315
Phone: (360) 200-5419
Fax: (360) 200-6736
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Specialties & licences
| Counselor (primary) | Taxonomy 101Y00000X · Licence CO61454634 (WA) |
|---|
Record details
| NPI number | 1376396325 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | SUDPT |
| Sole proprietor | No |
| NPI enumerated | April 9, 2024 |
| Last updated in NPPES | April 9, 2024 |
| Certification date | April 9, 2024 |
| Mailing address | Po Box 2394, Longview, WA 98632-8455 |
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