Provider Demographics
NPI:1952849457
Name:SAUNDERS-CLARKE, BERSUADA
Entity Type:Individual
Prefix:MRS
First Name:BERSUADA
Middle Name:
Last Name:SAUNDERS-CLARKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 WAGONER DR
Mailing Address - Street 2:SUITE 324
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-4608
Mailing Address - Country:US
Mailing Address - Phone:910-502-3225
Mailing Address - Fax:910-321-8563
Practice Address - Street 1:351 WAGONER DR
Practice Address - Street 2:SUITE 324
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4608
Practice Address - Country:US
Practice Address - Phone:910-502-3225
Practice Address - Fax:910-321-8563
Is Sole Proprietor?:No
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist