Individual
ANDREA RENEE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7180 CASCADE VALLEY CT STE 200, LAS VEGAS, NV 89128
(702) 570-1521
(702) 665-5876
Mailing address
11108 ROSSI AVE, LAS VEGAS, NV 89144-4030
(702) 570-1521
(702) 665-5876
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
01223
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861626293
NPI
NV
Enumeration date
05/13/2009
Last updated
06/05/2019
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