Individual
CORA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4075 PARK AVE, MEMPHIS, TN 38111-7400
(901) 584-8281
Mailing address
281 STAIRCASE DR, COLLIERVILLE, TN 38017-2370
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-271027
—
Other
Enumeration date
06/27/2023
Last updated
06/27/2023
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