Thelma Staley Clark, CRC, LPC

NPI #1346633187 in Redford, Michigan

Provider Information

NPI Number: 1346633187
Entity Type: Individual
Name: Thelma Staley Clark, CRC, LPC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Credential: CRC, LPC
Enumeration Date: Mar 17, 2015
Last Updated: Jul 15, 2016

Practice Location

Address: 9329 TELEGRAPH RD
City: Redford
State: Michigan
ZIP Code: 48239-1260
Phone: (313) 450-4500

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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