Individual
TIFFANY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11830 JENNER LN, SAINT LOUIS, MO 63138-1212
(314) 440-3020
(314) 653-2824
Mailing address
11830 JENNER LN, SAINT LOUIS, MO 63138-1212
(314) 440-3020
(314) 653-2824
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
03/19/2014
Last updated
03/19/2014
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