Individual
CHATIELA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
EDS
Contact information
Practice address
120 S UNIVERSITY DR STE F, PLANTATION, FL 33324-3346
(954) 559-2936
Mailing address
2601 N ROCK ISLAND RD APT 305, MARGATE, FL 33063-1226
(570) 497-0522
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
SS1819
FL
Other
Enumeration date
03/27/2024
Last updated
03/27/2024
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