Individual
DR. SHARONDA NICOLE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
(551) 996-4450
(551) 996-5729
Mailing address
14007 SUMMER ASH LN, HOUSTON, TX 77044-5017
(214) 738-2265
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
25MA10947800
NJ
2084P0804X
Child & Adolescent Psychiatry Physician
P1979
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080462703
—
TX
Enumeration date
10/28/2008
Last updated
12/08/2020
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