Individual
DOROTHY W CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA RD
Contact information
Practice address
405 W GRAND, DAYTON, OH 45405
(937) 723-3252
Mailing address
251 WALDORF DR, DAYTON, OH 45415-2818
(937) 681-5736
(937) 274-2886
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
5013
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5013
LICENCE
OH
01
—
857998
REGISTERED DIETITIAN
OH
Enumeration date
06/06/2008
Last updated
06/06/2008
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