NPI 1417394107 MELINDA SUSAN CLARK AVON PARK FL. Find Phone Number, Address, Contact details of medical healthcare providers | NPI Number Lookup

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Melinda Susan Clark - NPI: 1417394107

National Provider Identifier (NPI) is a 10-digit identification number which is issued to health care providers by the Centers for Medicare and Medicaid Services (CMS) in the United States(US). The NPI is introduced to replace of UPIN (unique provider identification number) and now NPI is the only required identifier for Medicare services, and NPI is also used by commercial healthcare insurers and by other payers.

Doctor Name: MELINDA SUSAN CLARK
NPI Number: 1417394107
Entity Type Code: Individual (1)
Gender: F
Credentials:
License Number:
Business Practice Address: 100 W College Dr Bldg E
Avon Park, FL - 338259348
Business Phone Number: 8634520106
Business Fax Number: 8634525376
Mailing Address: 100 W College Dr Bldg E,
AVON PARK
State: FL
Postal Code: 338259348
Phone Number: 8634520106
Fax Number: 8634525376
NPI Enumeration Date: 06/04/2013
NPI Last Update Date: 06/04/2013
Replacement NPI: 0
NPI Deactivation Date:
NPI Reactivation Date:

Taxonomy Information:

Healthcare Provider Taxonomy: 101YM0800X
License Number:
Healthcare Provider Taxonomy:
(Secondary)
Y
State:
Taxonomy Type: Behavioral Health & Social Service Providers
Taxonomy Classification: Counselor
Taxonomy Specialization: Mental Health
Taxonomy Definition:


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