Individual
SHAMARA LASHAI CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 E COLTER ST UNIT 477, PHOENIX, AZ 85016-3392
(812) 320-9812
Mailing address
1701 E COLTER ST UNIT 477, PHOENIX, AZ 85016-3392
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
11/05/2019
Last updated
11/05/2019
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