Individual
DESTINY SADE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8496 JULIA MARIE CIR, JACKSONVILLE, FL 32210-0408
(904) 497-5484
Mailing address
8496 JULIA MARIE CIR, JACKSONVILLE, FL 32210-0408
(904) 497-5484
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/27/2022
Last updated
10/27/2022
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