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Individual

KATHERINE SOMERS CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS,RDN,CNSC,LD

Contact information

Practice address
2615 E 20TH ST, JOPLIN, MO 64804-1039
(417) 624-7546
Mailing address
2443 S CHAPEL RD, CARTHAGE, MO 64836-8403
(417) 388-3812

Taxonomy

Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
2001013727
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2001013727
LICENSE
MO
Enumeration date
10/22/2018
Last updated
10/22/2018
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