Individual
BRIELLE SUMMER CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NJX3HZN03701960
HORIZON BLUE CROSS BLUE SHIELD
NJ
Enumeration date
12/14/2021
Last updated
12/14/2021
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