| Doctor Name: | EMILY CLARK |
| NPI Number: | 1538356597 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 162 E Carson St Ste A Colusa, CA - 959322880 |
| Business Phone Number: | 5304580520 |
| Business Fax Number: | 5304587751 |
| Mailing Address: | 162 E Carson St Ste A, COLUSA |
| State: | CA |
| Postal Code: | 959322880 |
| Phone Number: | 5304580520 |
| Fax Number: | 5304587751 |
| NPI Enumeration Date: | 10/03/2007 |
| NPI Last Update Date: | 11/22/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YS0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |