Cora Clark
Behavior Technician in Memphis, TN. Individual provider (NPI-1).
NPI number1316623804
StatusActive
Last updated in NPPESJun 27, 2023
Details
- NPI
- 1316623804
- Entity type
- Individual (NPI-1)
- Name
- Cora Clark
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 27, 2023
- Certification date
- Jun 27, 2023
- Last updated
- Jun 27, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | RBT-23-271027 | – | Yes |
Practice location
4075 Park AveMemphis, TN 38111-7400
Phone 901-584-8281
Mailing address
281 Staircase DrCollierville, TN 38017-2370
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 203 Behavior Technician providers in Memphis · All 16,727 providers in Memphis
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