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Individual

JAMELLE CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4747 EARHART BLVD, NEW ORLEANS, LA 70125
(504) 482-2600
Mailing address
4747 EARHART BLVD, NEW ORLEANS, LA 70125-1743

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
10
LA
101YM0800X
Mental Health Counselor
25
LA
101YM0800X
Mental Health Counselor
LA
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
03/09/2017
Last updated
07/19/2018
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