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1235854043
ANDRE MOSHEA CLARK
ENCINO, CA
NPI
1235854043
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: CA 125985)
Enumeration Date
2022-10-05
Last Update Date
2022-10-05
Business Address
ANDRE MOSHEA CLARK AMFT
15720 VENTURA BLVD
ENCINO, CA 91436-2914
Phone number: 818-927-0478
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Mailing Address
ANDRE MOSHEA CLARK AMFT
8668 SHANNONBROOK CT
LEMON GROVE, CA 91945-2668
Phone number: 850-241-3348
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