Individual
BRANDI DENISE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1060 WEBBER ST, THE DALLES, OR 97058-3749
(541) 296-5452
(541) 296-5263
Mailing address
1060 WEBBER ST, THE DALLES, OR 97058-3749
(541) 296-5452
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
109116
OR
Other
Enumeration date
05/08/2025
Last updated
05/08/2025
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