Amanda Lou Clark
Technician, Personal Care Attendant in Diana, WV. Individual provider (NPI-1).
NPI number1346851680
StatusActive
Last updated in NPPESJun 23, 2021
Details
- NPI
- 1346851680
- Entity type
- Individual (NPI-1)
- Name
- Amanda Lou Clark
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 11, 2020
- Certification date
- Jun 23, 2021
- Last updated
- Jun 23, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747P1801X | Technician, Personal Care Attendant | – | – | Yes |
Practice location
4631 Diana DrDiana, WV 26217-8777
Phone 304-636-9396
Mailing address
4631 Diana DrDiana, WV 26217-8777
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Other Personal Care Attendant providers in Diana, WV
- Renee ClarkNPI 1538952510
- Benjamin Lee CobbNPI 1326632167
- Chasidy GreenNPI 1801505474
- Melinda TaylorNPI 1225620230
All 5 Personal Care Attendant providers in Diana · All 6 providers in Diana
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