Individual
KENYADA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1910 MADISON AVE, MEMPHIS, TN 38104-2620
(601) 668-4432
Mailing address
1910 MADISON AVE, MEMPHIS, TN 38104-2620
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
TN8904
TN
104100000X
Social Worker
M10303
MS
Other
Enumeration date
04/02/2024
Last updated
04/02/2024
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