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Individual

GLENELL A CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
5102 N 166TH PLZ APT B202, OMAHA, NE 68116-3795
(402) 212-6406
Mailing address
5102 N 166TH PLZ APT B202, OMAHA, NE 68116-3795
(402) 212-6406

Taxonomy

Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
NE
372600000X
Adult Companion
NE
376J00000X
Homemaker
NE

Other

Enumeration date
12/09/2025
Last updated
12/09/2025
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