Individual
TELESE CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
328 E CAMP WISDOM RD, DUNCANVILLE, TX 75116
(972) 709-3448
Mailing address
328 E CAMP WISDOM RD, DUNCANVILLE, TX 75116-2706
(972) 709-3448
(972) 709-3451
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871924993
DAY HAB
TX
Enumeration date
04/04/2017
Last updated
08/23/2018
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