Individual
SHANEL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4123 HUNT PL NE, WASHINGTON, DC 20019-3500
(240) 216-4569
Mailing address
10119 ASTILL CT, WALDORF, MD 20603-3772
(240) 216-4569
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
03/10/2021
Last updated
03/10/2021
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