Individual
VANESSA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8305 BOTTOM WOODS CIR APT 102, TAMPA, FL 33637-5082
(813) 462-6504
Mailing address
PO BOX 272349, TAMPA, FL 33688-2349
(813) 462-6504
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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