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Individual

MRS. BRENDA L CLARKE

Active
Sole proprietor

Provider details

NPI number
Gender
F

Contact information

Practice address
25 W MAIN ST, WEST CARROLLTON, OH 45449-1419
(937) 866-0809
Mailing address
2311 ALPINE WAY, DAYTON, OH 45406-2102
(937) 278-4574

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2348436
OH
Enumeration date
03/17/2006
Last updated
07/09/2007
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