Individual
SHATONA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
34050 INDUSTRIAL RD, LIVONIA, MI 48150-1306
(734) 293-0034
Mailing address
11344 GODDARD CT, TAYLOR, MI 48180-6218
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
MI
Other
Enumeration date
11/25/2014
Last updated
11/25/2014
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