Individual
KATHLEEN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3000 41ST ST, MARATHON, FL 33050
(305) 434-9000
Mailing address
PO BOX 510795, KEY COLONY BEACH, FL 33051-0795
(305) 743-4111
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
RN 3079402
FL
Other
Enumeration date
09/04/2007
Last updated
09/04/2007
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