Individual
GILDA T. CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
133 PARK ST. NE, VIENNA, VA 22180
(703) 281-4928
(703) 242-1454
Mailing address
133 PARK ST. NE, VIENNA, VA 22180
(703) 281-4928
(703) 242-1454
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PRC14368
DC
Other
Enumeration date
02/08/2012
Last updated
05/29/2013
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