Individual
ASHLEY MARIE CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9 MELISSA DR, FARMINGVILLE, NY 11738-2867
(631) 406-3871
Mailing address
9 MELISSA DR, FARMINGVILLE, NY 11738-2867
(631) 406-3871
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
344521
NY
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/09/2022
Last updated
02/02/2023
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