Individual
CHANEL MARIE CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10001 LAKE FOREST BLVD, SUITE 616, NEW ORLEANS, LA 70127-6200
(504) 240-3056
Mailing address
7833 BURTHE ST, NEW ORLEANS, LA 70118-3946
(504) 240-3056
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
13107
LA
Other
Enumeration date
04/07/2015
Last updated
04/07/2015
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