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General NPI Number Information
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NPI Number | 1114438314
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Entity Type | Individual
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Provider Name | AIMEE CLARKE LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/16/2017
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Last Update Date | 03/23/2018
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Provider Practice Location Address
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Address Line | 8105 RASOR BLVD STE 120
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City | PLANO
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State | TX
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Zip | 75024-0116
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Country | US
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Telephone | 816-258-1987
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Fax |
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Provider Business Mailing Address
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Address Line | 13904 POMEGRANATE DR
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City | FRISCO
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State | TX
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Zip | 75035-7008
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2010039507
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 57516
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License Number State | TX
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