Individual
DORETHA L CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1230 N HIGHLAND AVE, AURORA, IL 60506-1401
(630) 966-4301
(630) 859-2994
Mailing address
1230 N HIGHLAND AVE, AURORA, IL 60506-1401
(630) 966-4301
(630) 859-2994
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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