Most Relevant Information
Provider Data
| NPI Number: | 1003366535 |
| Provider Name: | SHERRELL CLARK |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/07/2016 |
| Last Updated: | 06/26/2024 |
Provider Practice Location
2085 RUSTIN AVE STE 1
RIVERSIDE
CA
925072498
Practice Location Phone/Fax
| Phone: | 9519557320 |
| Fax: |
Provider Mailing Location
883 OLEANDER ST
HEMET
CA
925435876
Provider Mailing Phone/Fax
| Phone: | 5037542398 |
| Fax: |