Doctor Name: | DOLORES CLARKE |
NPI Number: | 1225373293 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA |
License Number: | 6401005483 |
Business Practice Address: | 2051 Rosa Parks Blvd Detroit, MI - 482161556 |
Business Phone Number: | 3132745840 |
Business Fax Number: | 3132748277 |
Mailing Address: | 120 Parsons St, DETROIT |
State: | MI |
Postal Code: | 482012002 |
Phone Number: | 3138311000 |
Fax Number: | 3135795942 |
NPI Enumeration Date: | 12/03/2012 |
NPI Last Update Date: | 12/03/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 6401005483 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
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 |