Individual
ANDREA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11616 SOUTHFORK AVE STE 403, BATON ROUGE, LA 70816-5241
(504) 877-2644
Mailing address
11616 SOUTHFORK AVE STE 403, BATON ROUGE, LA 70816-5241
(504) 877-2644
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
LA
174400000X
Specialist
Primary
—
—
Other
Enumeration date
04/13/2021
Last updated
01/15/2026
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