NPI 1023342862

Tanya Marie Clark, JD

Practitioner Contractor Southfield, MI

Practice location

Address: 17601 Addison St, Southfield, MI 48075-2764
Phone: (248) 227-2029
Mailing address: PO Box 182, Southfield, MI 48037-0182

Registered specialties (2)

Contractor Primary

Other Service Providers Taxonomy 171W00000X

Other Contractor providers in Michigan →

Community Health Worker

Other Service Providers Taxonomy 172V00000X

Other Community Health Worker providers in Michigan →

Registry record

NPI: 1023342862
Entity type: Individual
Sex (as registered): Female
NPI issued: 27 Sep 2009
Record last updated: 27 Sep 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.