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Individual

LARRY ISAIAH CLARKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
QMHA

Contact information

Practice address
5860 S PECOS RD, STE. 300, LAS VEGAS, NV 89120-5428
(702) 538-9474
(702) 834-8437
Mailing address
5680 S PECOS RD, STE. 300, LAS VEGAS, NV 89120-1960
(702) 538-9474
(702) 834-8437

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1316279185
NV
Enumeration date
11/30/2010
Last updated
01/14/2015
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