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NPI Code Detail

MEDICARE: LINDSEY RICHELLE CLARK

MEDICARE: LINDSEY RICHELLE CLARK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-18-63131TN
2106S00000XBehavior TechnicianTN

General Provider Information

NPI Number : 1740894955
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSEY RICHELLE CLARK
Provider Business Mailing Address
First Line : 9 COUNTY ROAD 191
Second Line :
City : OXFORD
State : MS
Zip : 38655-8677
Country : US
Telephone Number : 901-584-8281
Fax Number :
Provider Business Practice Location Address
First Line : 3720 ALUMNI AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38111-5914
Country : US
Telephone Number : 901-584-8281
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/04/2020
Last Update Date : 09/04/2020

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Directions to “ LINDSEY RICHELLE CLARK ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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