Individual
ELLA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CM/SC
Contact information
Practice address
28 BURKE RD, DELBARTON, WV 25670-6041
(304) 444-2197
Mailing address
28 BURKE RD, DELBARTON, WV 25670-6041
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
WV
Other
Enumeration date
01/15/2021
Last updated
01/15/2021
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