Burruss- Clark, Jettanna

Burruss- Clark, Jettanna is an sole proprietor health care provider with primary practice located at 22 Meadow Pl , Waldorf MD 20601-2924. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Counselor. Other Service Providers / Case Manager/Care Coordinator is her primary health care specialty. Burruss- Clark, Jettanna can be contacted via phone (240) 810-3952.

Contact Information

Primary practice address
22 Meadow Pl Waldorf MD 20601-2924
Phone: (240) 810-3952
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Behavioral Health & Social Service Providers / Counselor 101Y00000X

Profile Details

NPI number 1902590227
LBN Legal business name Burruss- Clark, Jettanna
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 8th, 2023
Last updated Jun 14th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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