Individual
DESTINEE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4241 E PIEDRAS DR STE 171, SAN ANTONIO, TX 78228-1409
(225) 385-4543
(866) 825-9703
Mailing address
4241 E PIEDRAS DR STE 171, SAN ANTONIO, TX 78228-1409
(225) 385-4543
(866) 825-9703
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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