Jeremy Clark
Jeremy Clark is a Mental Health Counselor in Pocatello, Idaho. Registered with an NPI since 2008.
- In the registry since
- 2008
Practice location Address checks out
2055 Garrett Way Ste 1Pocatello, ID 83201-5100
Phone: (208) 236-1600
Fax: (208) 236-6695
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Specialties & licences
| Mental Health Counselor (primary) | Taxonomy 101YM0800X |
|---|
Record details
| NPI number | 1851551873 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | June 12, 2008 |
| Last updated in NPPES | June 12, 2008 |
| Mailing address | 2055 Garrett Way, Ste 1, Pocatello, ID 83201-5100 |
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