Individual
BERNADETTE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDN
Contact information
Practice address
809 TURNPIKE AVE, CLEARFIELD, PA 16830-1232
(814) 765-5341
(814) 768-2043
Mailing address
809 TURNPIKE AVE, CLEARFIELD, PA 16830-1232
(814) 342-0676
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN001432
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
495510
REGISTERED DIETICIAN ID NUMBER
PA
01
—
DN001432
LICENSE NUMBER
PA
Enumeration date
12/03/2014
Last updated
08/17/2016
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