Individual
MS. CRYSTAL A CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMA
Contact information
Practice address
331 JAMESTOWN CT, COLUMBUS, OH 43228-4030
(601) 480-3968
Mailing address
PO BOX 2892, COLUMBUS, OH 43216-2892
(601) 480-3968
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
—
—
372600000X
Adult Companion
—
—
3747A0650X
Attendant Care Provider
—
—
3747P1801X
Personal Care Attendant
Primary
—
—
376J00000X
Homemaker
—
—
Other
Enumeration date
03/08/2012
Last updated
03/09/2012
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