Clark, Deja

Clark, Deja is an individual health care provider with primary practice located at 1483 E 135Th St # Na , East Cleveland OH 44112-2460. She recently has only one registered license in Nursing Service Related Providers / Home Health Aide, which is considered as her primary health care specialty. Clark, Deja can be contacted via phone (216) 541-0551.

Contact Information

Primary practice address
1483 E 135Th St # Na East Cleveland OH 44112-2460
Phone: (216) 541-0551
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Home Health Aide 374U00000X Ohio

Profile Details

NPI number 1699371559
LBN Legal business name Clark, Deja
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2020
Last updated Dec 7th, 2020 - about 4 years ago

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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Identifiers

StateTypeNumberIssuer
All States NPI 1699371559 NPPES
Ohio MEDICAID 0352191

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