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General NPI Number Information
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NPI Number | 1578377164
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Entity Type | Individual
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Provider Name | WHITNEY CLARKE
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Gender | Female
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 12781 MIRAMAR PKWY STE 203
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City | MIRAMAR
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State | FL
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Zip | 33027-2908
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Country | US
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Telephone | 954-225-5199
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Fax |
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Provider Business Mailing Address
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Address Line | 7650 FARRAGUT ST
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City | HOLLYWOOD
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State | FL
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Zip | 33024-2628
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Country | US
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Telephone | 954-225-5199
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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