Individual
DESTINY RAVEN CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6131 CHAMBERLAIN PL APT 202, WINSTON SALEM, NC 27103-7209
(910) 585-6206
Mailing address
6131 CHAMBERLAIN PL APT 202, WINSTON SALEM, NC 27103-7209
(910) 585-6206
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
NC
Other
Enumeration date
09/26/2025
Last updated
09/26/2025
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