Clark, Andrea Rachele
Clark, Andrea Rachele is an sole proprietor health care provider with primary practice located at 1818 W Lindsey St Ste C120 , Norman OK 73069-4169. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Clark, Andrea Rachele can be contacted via phone (405) 801-2400.Contact Information
Primary practice address
1818 W Lindsey St Ste C120
Norman OK 73069-4169
Phone: (405) 801-2400
Fax: (405) 701-1185
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 970 | Oklahoma |
Profile Details
| NPI number | 1912034596 |
|---|---|
| LBN Legal business name | Clark, Andrea Rachele |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 28th, 2007 |
| Last updated | Jul 1st, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1912034596 | NPPES |
| Oklahoma | MEDICAID | 200036470-A |
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