Clark, Madison
Clark, Madison is an sole proprietor health care provider with primary practice located at 11615 Northgate Trl , Roswell GA 30075-2335. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Clark, Madison can be contacted via phone (678) 643-5421.Contact Information
Primary practice address
11615 Northgate Trl
Roswell GA 30075-2335
Phone: (678) 643-5421
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X |
Profile Details
| NPI number | 1841645389 |
|---|---|
| LBN Legal business name | Clark, Madison |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 3rd, 2016 |
| Last updated | May 3rd, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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