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Winnifred D Clark
School Counselor in Wickenburg, Arizona
NPI 1164556965

Winnifred D Clark is a School Counselor based in El Mirage, AZ and is specialized in School. Winnifred D Clark practices in Wickenburg, AZ. The NPI Number for Winnifred D Clark is 1164556965 and holds a License No. (Arizona).

The current practice location address for Winnifred D Clark is 920 S. Vulture Mine Road, Wickenburg, AZ and can be reached out via phone at 928-684-6714.

Location: 920 S. Vulture Mine Road, Wickenburg, AZ, 85335-6001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164556965
Provider Name
Winnifred D Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
920 S. Vulture Mine Road, Wickenburg, AZ, 85335-6001
Phone Number
928-684-6714
Fax Number
Provider Enumeration Date
03/15/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
109869 01 AZ AHCCCS PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
920 S. Vulture Mine Road
City
Wickenburg
State
Arizona
Zip
85390
Phone Number
928-684-6714
Fax Number
person
Provider Business Mailing Address Details
Address
920 S. Vulture Mine Road
City
Wickenburg
State
Arizona
Zip
85390
Phone Number
928-684-6714
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
School
Taxonomy
101YS0200X
License No.
(Arizona)
Definition
Definition to come...
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