Individual
CLARISSA VICTORIA TRADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1532 OCEAN HWY, POCOMOKE CITY, MD 21851-3023
(443) 437-7128
(443) 437-7131
Mailing address
3564 NAVIGATOR DR, GREENBACKVILLE, VA 23356-2508
(757) 894-8941
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002097361
VA
Other
Enumeration date
04/28/2021
Last updated
04/28/2021
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