| NPI | 1861945271 |
|---|---|
| Former Name | STEPHANIE RENEE CLARKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2017013446) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2017013446) |
| 103TS0200X Psychologist, School | |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2023-10-03 |