Individual
BRIAN JOSEPH CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
2120 S MCCLINTOCK DR STE 105, TEMPE, AZ 85282-2692
(480) 804-0326
(480) 804-0083
Mailing address
1400 E SOUTHERN AVE STE 735, TEMPE, AZ 85282-5699
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LAC-17185
AZ
Other
Enumeration date
06/14/2018
Last updated
11/08/2018
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