Individual
VERONICA ANN CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPE
Contact information
Practice address
710 S HOLLY ST, SILOAM SPRINGS, AR 72761-3304
(479) 750-2020
(479) 524-5197
Mailing address
PO BOX 6430, SPRINGDALE, AR 72766-6430
(479) 750-2020
(479) 524-5197
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
91-2E
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5Y342
BLUE SHIELD PROVIDER #
AR
Enumeration date
06/30/2006
Last updated
07/08/2007
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