Individual
ADRIENNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
6615 QUINCY ST, PHILADELPHIA, PA 19119-2719
(215) 391-0306
Mailing address
6615 QUINCY ST, PHILADELPHIA, PA 19119-2719
(215) 391-0306
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
09/30/2013
Last updated
09/30/2013
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