Individual
MARDEE CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5045 W BASELINE RD # 497, LAVEEN, AZ 85339-7392
(480) 896-8919
Mailing address
5045 W BASELINE RD # 497, LAVEEN, AZ 85339-7392
(480) 896-8919
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LCSW-20575
AZ
1041C0700X
Clinical Social Worker
Primary
LCSW-20575
AZ
Other
Enumeration date
01/30/2023
Last updated
12/22/2023
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