Provider Information for 1285051276
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DARRELL CLARKE LPC
Sex: Male
NPI: 1285051276
Last Updated: 2014-03-27
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1285051276 | ||||||||
| Enumeration Date | 2014-03-27 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 96 CROSSROADS BLVD 250 SAN ANTONIO, TX 78201-6523 United States Phone: 210-736-0106 | Fax:210-736-2609 | ||||||||
| Primary Practice Address | 96 CROSSROADS BLVD 250 SAN ANTONIO, TX 78201-6523 United States Phone: 210-736-0106 | Fax:210-736-2609 | ||||||||
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