Individual
NICOLE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5317 BELFIELD AVE, PHILADELPHIA, PA 19144-5815
(215) 594-6329
Mailing address
5317 BELFIELD AVE, PHILADELPHIA, PA 19144-5815
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
NBDT-00117
PA
Other
Enumeration date
04/13/2023
Last updated
04/13/2023
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