Provider Demographics
NPI:1588067979
Name:CLARKE, CLARE (DCLIN PSY)
Entity type:Individual
Prefix:DR
First Name:CLARE
Middle Name:
Last Name:CLARKE
Suffix:
Gender:F
Credentials:DCLIN PSY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 SWIFT BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1215
Mailing Address - Country:US
Mailing Address - Phone:832-293-1200
Mailing Address - Fax:
Practice Address - Street 1:2550 NORTH LOOP W
Practice Address - Street 2:SUITE 260-1
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-8902
Practice Address - Country:US
Practice Address - Phone:281-451-8376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36757103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical