Clark, Tina Marie

Clark, Tina Marie is an individual health care provider with primary practice located at 411 S Central Ave , Idabel OK 74745-6059. She recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as her primary health care specialty. Clark, Tina Marie can be contacted via phone (580) 286-5045.

Contact Information

Primary practice address
411 S Central Ave Idabel OK 74745-6059
Phone: (580) 286-5045
Fax: (580) 286-5721
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X

Profile Details

NPI number 1871000877
LBN Legal business name Clark, Tina Marie
Credentials FSP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2017
Last updated Dec 29th, 2017 - about 8 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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