| NPI | 1003967449 |
|---|---|
| Former Name | JUDITH H CLARKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: RI MHC00076) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2007-01-14 |
| Last Update Date | 2011-12-12 |