Individual
DOREEN CHARA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT,LPC
Contact information
Practice address
2435 E SOUTHERN AVE STE 2, TEMPE, AZ 85282-7628
(480) 839-9350
(480) 839-4412
Mailing address
2435 E SOUTHERN AVE STE 2, TEMPE, AZ 85282-7628
(480) 839-9350
(480) 839-4412
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
SAC0564
AZ
106H00000X
Marriage & Family Therapist
Primary
LMFT0191
AZ
Other
Enumeration date
05/22/2007
Last updated
05/27/2010
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