Doctor Name: | MS. KATHERINE H. CLARK |
NPI Number: | 1710068440 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. VOC REHAB |
License Number: | |
Business Practice Address: | 5th Ave & Roosevelt Rd Edward Hines Jr Va Hospital 116a6 Hines, IL - 60141 |
Business Phone Number: | 7082027122 |
Business Fax Number: | |
Mailing Address: | 311 N Waiola Ave, LA GRANGE PARK |
State: | IL |
Postal Code: | 605261823 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 10/18/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |