Clark, Therisa
Clark, Therisa is an sole proprietor health care provider with primary practice located at 421 Oakmont Dr , Poca WV 25159. She recently has only one registered license in Nursing Service Related Providers / Personal Care Attendant, which is considered as her primary health care specialty. Clark, Therisa can be contacted via phone (304) 755-4627.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Related Providers / Personal Care Attendant | 3747P1801X |
Profile Details
| NPI number | 1710485230 |
|---|---|
| LBN Legal business name | Clark, Therisa |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 30th, 2018 |
| Last updated | Jan 30th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710485230 | NPPES |
| Other | G23890026691 | PROVIDER ID |
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