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General NPI Number Information
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NPI Number | 1922526854
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Entity Type | Individual
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Provider Name | ROCHELLE S CLARKE PHD, LMFT
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Gender | Female
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Dates
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Enumeration Date | 08/30/2017
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Last Update Date | 08/30/2017
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Provider Practice Location Address
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Address Line | 2800 WESTON RD STE 100202
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City | WESTON
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State | FL
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Zip | 33331-3638
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Country | US
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Telephone | 954-336-6697
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Fax |
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Provider Business Mailing Address
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Address Line | 775 SW 148TH AVE APT 1610
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City | DAVIE
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State | FL
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Zip | 33325-3093
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT3183
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License Number State | FL
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