Individual
TANIESA U CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
894 FOUNTAIN AVE APT 533, BROOKLYN, NY 11239-2648
(347) 623-8272
Mailing address
894 FOUNTAIN AVE APT 533, BROOKLYN, NY 11239-2648
(347) 623-8272
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
NY
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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