Individual
MRS. MELBA LYNETTE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1010 ANTIETAM AVE, DETROIT, MI 48207-2832
(313) 303-7585
Mailing address
1010 ANTIETAM AVE, DETROIT, MI 48207-2832
(313) 671-3188
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6401017626
MI
Other
Enumeration date
11/11/2019
Last updated
09/11/2025
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