Individual
COLLEEN CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4930 DARIEN DR, LIVERPOOL, NY 13088-5802
(585) 491-0056
Mailing address
4930 DARIEN DR, LIVERPOOL, NY 13088-5802
(585) 491-0056
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
335906
NY
Other
Enumeration date
01/02/2025
Last updated
01/02/2025
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