NPI 1124668694

Genese Calloway Clark

Practitioner Case Manager/Care Coordinator New Haven, CT

Practice location

Address: 458 Grand Ave STE 103, New Haven, CT 06513-3873
Phone: (203) 850-4737

Registered specialties (2)

Case Manager/Care Coordinator Primary

Other Service Providers Taxonomy 171M00000X

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Counselor

Behavioral Health & Social Service Providers Taxonomy 101Y00000X

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Registry record

NPI: 1124668694
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Jan 2020
Record last updated: 13 Jan 2020

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.