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ROBIN ARDELLE CLARK

>> Community Health Worker >> Other Service Providers

Registrant NPI Number: 1568949469

Individual Registrant:
 ROBIN ARDELLE CLARK 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
32270 OLD WOMAN SPRINGS RD  LUCERNE VALLEY, CA 92356 US
Tel: 760-248-6612  Fax: --

Contact information for business:
PO BOX 1927  BIG BEAR LAKE, CA 92315-1927 US
Tel: 909-866-5070  Fax: --

Registration Information:
NPI: 1568949469
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y172V00000XOther Service Providers
Community Health Worker

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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