Individual
DEXTER CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
5050 ISELIN AVE, BRONX, NY 10471-2915
(718) 549-6700
(718) 796-4614
Mailing address
4300 BRUNER AVE, BRONX, NY 10466-1806
(347) 202-5596
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/22/2011
Last updated
11/22/2011
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