Individual
KATHERINE NICOLE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3223 N OLIVER ST, WICHITA, KS 67220-2106
(316) 267-5437
(316) 558-3400
Mailing address
3223 N OLIVER ST, WICHITA, KS 67220-2106
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
KS
Other
Enumeration date
10/22/2010
Last updated
10/22/2010
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