Individual
DELORES CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13929 HARPER AVE, DETROIT, MI 48213-3672
(313) 371-0055
(313) 371-1409
Mailing address
14667 CEDARGROVE ST, DETROIT, MI 48205-3609
(313) 717-1988
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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