Individual
JADA CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S.
Contact information
Practice address
6 MATHIS DR NW, ROME, GA 30165-1242
(706) 233-9023
(706) 232-6099
Mailing address
608 SOUTH AVE SW, ROME, GA 30165-4218
(706) 233-9023
(706) 232-6099
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1014M0800X
—
GA
Enumeration date
12/30/2015
Last updated
12/30/2015
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