Individual
DOMINIQUE RENAE CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
102 N DENVER AVE, TULSA, OK 74103-1806
(918) 582-1200
(918) 560-1399
Mailing address
650 S PEORIA AVE, TULSA, OK 74120-4429
(918) 587-9471
(918) 560-1399
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/12/2013
Last updated
09/12/2013
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