Individual
IDELIZ CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25 MANILLA AVE, SPRINGFIELD, MA 01109-1716
(413) 557-4277
Mailing address
25 MANILLA AVE, SPRINGFIELD, MA 01109-1716
(413) 557-4277
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/25/2016
Last updated
01/25/2016
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