Individual
MS. JESSICA LYN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
COMDT (CG-1122), U.S. COAST GUARD, 2100 2ND ST SW, SUITE 5314, WASHINGTON, DC 20593-0001
(757) 483-8597
Mailing address
COMDT (CG-1122), U.S. COAST GUARD, 2100 2ND ST SW, SUITE 5314, WASHINGTON, DC 20593-0001
(305) 535-4535
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
247200000X
Other Technician
—
—
Other
Enumeration date
01/06/2006
Last updated
01/24/2020
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