Individual
EBONI TASHLIN CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LMSW
Contact information
Practice address
517 ADVANCEMENT AVE APT 4, DURHAM, NC 27703-6490
(313) 410-1871
Mailing address
517 ADVANCEMENT AVE APT 4, DURHAM, NC 27703-6490
(313) 410-1871
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
6801089446
MI
1041C0700X
Clinical Social Worker
Primary
C007345
NC
Other
Enumeration date
10/03/2010
Last updated
10/12/2018
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