Ebonye Patrice Clark
Peer Specialist in Midwest City, OK. Individual provider (NPI-1).
NPI number1962998062
StatusActive
Last updated in NPPESJul 2, 2018
Details
- NPI
- 1962998062
- Entity type
- Individual (NPI-1)
- Name
- Ebonye Patrice Clark
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 2, 2018
- Last updated
- Jul 2, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 175T00000X | Peer Specialist | – | – | Yes |
Practice location
1704 Center Dr Apt 2Midwest City, OK 73110-2869
Phone 405-679-7979
Mailing address
1704 Center Dr Apt 2Midwest City, OK 73110-2869
Phone 405-679-7979
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All 31 Peer Specialist providers in Midwest City · All 1,676 providers in Midwest City
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