Individual
ALEXANDRA SIERRA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, SSP, NCSP
Contact information
Practice address
14539 ELMBRIDGE AVE, BATON ROUGE, LA 70819-2016
(225) 603-8323
Mailing address
14539 ELMBRIDGE AVE, BATON ROUGE, LA 70819-2016
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770056590
—
LA
Enumeration date
01/03/2019
Last updated
04/10/2019
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