Provider Demographics
NPI:1417820275
Name:CLARKE, NOVLETTE (CERTIFIED LIFE COACH)
Entity type:Individual
Prefix:
First Name:NOVLETTE
Middle Name:
Last Name:CLARKE
Suffix:
Gender:F
Credentials:CERTIFIED LIFE COACH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4552 BRONX BLVD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10470-1410
Mailing Address - Country:US
Mailing Address - Phone:347-204-8824
Mailing Address - Fax:
Practice Address - Street 1:4552 BRONX BLVD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10470-1410
Practice Address - Country:US
Practice Address - Phone:347-204-8824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-27
Last Update Date:2025-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty