| Doctor Name: | DEBORAH A. CLARK |
| NPI Number: | 1053421453 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 0701003008 |
| Business Practice Address: | 600 Medical Dr Suite A Hampton, VA - 236661769 |
| Business Phone Number: | 7577880600 |
| Business Fax Number: | 7577880932 |
| Mailing Address: | 2501 Washington Ave, 1st Floor NEWPORT NEWS |
| State: | VA |
| Postal Code: | 236074327 |
| Phone Number: | 7572450217 |
| Fax Number: | 7572454918 |
| NPI Enumeration Date: | 08/30/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0701003008 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |