Individual
LAFAYETTE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3941 ASIMOV PL, LAS VEGAS, NV 89115-0386
(702) 525-8386
Mailing address
3941 ASIMOV PL, LAS VEGAS, NV 89115-0386
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/03/2013
Last updated
10/03/2013
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