Clark, Tanya Marie

Clark, Tanya Marie is an individual health care provider with primary practice located at 17601 Addison St , Southfield MI 48075-2764. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Contractor, Other Service Providers / Community Health Worker. Other Service Providers / Contractor is her primary health care specialty. Clark, Tanya Marie can be contacted via phone (248) 227-2029.

Contact Information

Primary practice address
17601 Addison St Southfield MI 48075-2764
Phone: (248) 227-2029
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1023342862
LBN Legal business name Clark, Tanya Marie
Credentials J.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2009
Last updated Sep 27th, 2009 - about 16 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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