Individual
TALESIA CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6701 N 22ND ST, TAMPA, FL 33610-1338
(813) 846-5579
Mailing address
6701 N 22ND ST, TAMPA, FL 33610-1338
(813) 846-5579
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
03/16/2020
Last updated
03/16/2020
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