Individual
D'ANDRE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17235 N 75TH AVE, GLENDALE, AZ 85308-0831
(480) 878-7115
Mailing address
21244 N 262ND DR, BUCKEYE, AZ 85396-7600
(661) 303-0864
(661) 303-0864
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/26/2025
Last updated
11/26/2025
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