Most Relevant Information
Provider Data
| NPI Number: | 1003319807 |
| Provider Name: | MICHAEL CLARK-BORENSTEIN |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | A13607 |
Most Important Dates
| Enumeration Date: | 03/18/2018 |
| Last Updated: | 06/14/2022 |
Provider Practice Location
3800 MEETING ST STE 230
INDIAN TRAIL
NC
280796582
Practice Location Phone/Fax
| Phone: | 7042370705 |
| Fax: | 9802361356 |
Provider Mailing Location
3800 MEETING ST STE 230
INDIAN TRAIL
NC
280796582
Provider Mailing Phone/Fax
| Phone: | 7042370705 |
| Fax: | 9802361356 |