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Individual

MS. LEILA SUZANNE CLARK

Active
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Individual

MS. LEILA SUZANNE CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMSW, LPN

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
099205-1
NY
164W00000X
Licensed Practical Nurse
258103-1
NY

Other

Enumeration date
10/31/2008
Last updated
01/24/2017
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