Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 37AC00521200 | NJ |
NPI | 1992467336 |
---|---|
Provider Name | Toriann Clarke |
First Address | Philadelphia, PA 19128-3747 |
Second Address | Voorhees, NJ 08043-4414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2021 |
Last Update Date | 13/10/2021 |