Provider Information for 1316246283
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Ms. NORMA GAIL CLARK M.A., L.P.C.
Sex: Female
NPI: 1316246283
Last Updated: 2024-01-03
Certification Date: 2024-01-03
Certification Date: 2024-01-03
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1316246283 | ||||||||||||
| Enumeration Date | 2011-03-17 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 261 PRIVATE ROAD 6059 WIERGATE, TX 75977-9792 United States Phone: 409-790-9989 | Fax: | ||||||||||||
| Primary Practice Address | 261 PRIVATE ROAD 6059 WIERGATE, TX 75977-9792 United States Phone: 409-790-9989 | Fax: | ||||||||||||
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