Individual
MR. CLARENCE EVERSLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
497 ROCKAWAY AVE, VALLEY STREAM, NY 11581-1909
(718) 845-2621
(718) 845-2622
Mailing address
61 ESSEX RD, ELMONT, NY 11003-2022
(908) 387-3288
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/16/2020
Last updated
11/16/2020
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