Charlotte Clark

NPI 1316298797 · on the registry since 2012

Practice

Address: 700 Se Cross St
Mount Sterling, IL 62353
Phone: (217) 773-3325
Fax: (217) 773-2425
Organisation at this address: Mental Health Centers Of Western Illinois
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 15

Registry record

Primary taxonomy: 164W00000X
164W00000X
Licence states on file: IL
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2012-09-26

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois