Individual
DESSIE L CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4301 N FEDERAL HWY STE 2, POMPANO BEACH, FL 33064-6519
(888) 880-9270
Mailing address
208 WASHINGTON ST, SHREVEPORT, LA 71104-3343
(318) 607-7302
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
009296774
LA
Other
Enumeration date
09/02/2013
Last updated
09/02/2013
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