Individual
MRS. VIVENE CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SP.ED. MS.
Contact information
Practice address
1419 E 58TH ST, BROOKLYN, NY 11234-4119
(718) 531-0515
Mailing address
1419 E 58TH ST, BROOKLYN, NY 11234-4119
(718) 531-0515
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
SPECIAL ED
NY
Other
Enumeration date
12/31/2009
Last updated
01/08/2010
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