Individual
RADONNA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25 KESSEL CT STE 102, MADISON, WI 53711-6227
(608) 280-2700
Mailing address
25 KESSEL CT STE 102, MADISON, WI 53711-6227
(608) 208-2700
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
499004280
SSNS
TX
Enumeration date
08/26/2022
Last updated
08/26/2022
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