| Doctor Name: | JANELLE ELIZABETH CLARK |
| NPI Number: | 1043314040 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.P.C. |
| License Number: | 1899 |
| Business Practice Address: | 2525 N Mayfair Rd Suite 200 Wauwatosa, WI - 532261403 |
| Business Phone Number: | 4144768183 |
| Business Fax Number: | 4144768465 |
| Mailing Address: | 2525 N Mayfair Rd, Suite 200 WAUWATOSA |
| State: | WI |
| Postal Code: | 532261403 |
| Phone Number: | 4144768183 |
| Fax Number: | 4144768465 |
| NPI Enumeration Date: | 09/11/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 1899 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | NC |
| 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 |