Individual
SAMANTHA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
1570 MIDWAY PL, MENASHA, WI 54952-1165
(920) 720-1802
Mailing address
1570 MIDWAY PL, MENASHA, WI 54952-1165
(920) 720-1802
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
01/17/2023
Last updated
01/17/2023
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