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General NPI Number Information
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NPI Number | 1235727694
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Entity Type | Individual
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Provider Name | MRS. SARAH LOUISE CLARK
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Gender | Female
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Dates
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Enumeration Date | 12/31/2020
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Last Update Date | 03/18/2022
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Provider Practice Location Address
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Address Line | 6623 HYDE RD
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City | WINDSOR
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State | OH
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Zip | 44099-9736
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Country | US
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Telephone | 440-669-3125
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Fax |
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Provider Business Mailing Address
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Address Line | 6623 HYDE RD
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City | WINDSOR
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State | OH
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Zip | 44099-9736
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Country | US
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Telephone | 440-669-3125
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | 2809643
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License Number State | OH
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