Individual
MS. JENNIFER ISABEL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
348 E 146TH ST, BRONX, NY 10451-5702
(718) 585-0614
Mailing address
539 LENOX AVE APT 3A, NEW YORK, NY 10037-1815
(718) 585-0614
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/06/2012
Last updated
11/06/2012
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