Individual
MICHELLE CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPT , CNA
Contact information
Practice address
4532 BROWNS MILL FERRY RD, LITHONIA, GA 30038-4528
(404) 437-3540
(404) 437-3540
Mailing address
4532 BROWNS MILL FERRY RD, LITHONIA, GA 30038-4528
(678) 362-1552
Taxonomy
Speciality
Code
Description
License number
State
2472E0500X
EEG Technician
Primary
C9P4H9A3
GA
376K00000X
Nurse's Aide
CN0000001529
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000
—
GA
Enumeration date
01/12/2018
Last updated
01/22/2019
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