Individual
CASONDRA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17874 W BLOOMFIELD RD, SURPRISE, AZ 85388-5619
(480) 465-2920
Mailing address
17874 W BLOOMFIELD RD, SURPRISE, AZ 85388-5619
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
01/22/2026
Last updated
01/22/2026
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