MS. Nicollette Shautria Clark
NPI #1831746817 in Monticello, Mississippi
Provider Information
- NPI Number
- 1831746817
- Entity Type
- Individual
- Name
- MS. Nicollette Shautria Clark
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Technician - Attendant Care Provider
- Enumeration Date
- Aug 23, 2019
- Last Updated
- Aug 23, 2019
Practice Location
- Address
- 940 NEAL PL
- City
- Monticello
- State
- Mississippi
- ZIP Code
- 39654-7003
- Phone
- (601) 522-9025
Specialties & Taxonomy Codes
| Specialty |
|---|
| Technician - Attendant Care Provider — Attendant Care Provider |
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