Individual
MACKENZIE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1206 E WARNER RD STE 115, GILBERT, AZ 85296-3133
(480) 590-3915
Mailing address
1206 E WARNER RD STE 115, GILBERT, AZ 85296-3133
(480) 590-3915
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-23593
AZ
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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