Provider Information for 1578183034
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STEPHEN CLAY MARKS LPC
Sex: Male
NPI: 1578183034
Last Updated: 2023-07-21
Certification Date: 2023-07-21
Certification Date: 2023-07-21
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1578183034 | ||||||||||||
| Enumeration Date | 2020-04-24 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 2157 ELLIJAY, GA 30540-0037 United States Phone: 706-669-3260 | Fax: | ||||||||||||
| Primary Practice Address | 216 DOGWOOD DR ELLIJAY, GA 30540-5527 United States Phone: 706-669-3260 | Fax: | ||||||||||||
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