Individual
ALTHERESA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
111 NW 183RD ST STE 404, MIAMI, FL 33169-4619
(786) 524-4001
(786) 551-1968
Mailing address
111 NW 183RD ST STE 404, MIAMI, FL 33169-4619
(786) 524-4001
(786) 551-1968
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
SW13295
FL
1041C0700X
Clinical Social Worker
Primary
SW13295
FL
Other
Enumeration date
05/02/2016
Last updated
03/05/2024
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