Kortney Booth Clark, Case Management
Case Manager/Care Coordinator in Evanston, WY. Individual provider (NPI-1).
NPI number1477024149
StatusActive
Last updated in NPPESDec 6, 2018
Details
- NPI
- 1477024149
- Entity type
- Individual (NPI-1)
- Name
- Kortney Booth Clark
- Credential
- Case Management
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 6, 2018
- Last updated
- Dec 6, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171M00000X | Case Manager/Care Coordinator | – | – | Yes |
Practice location
322 Gannett DrEvanston, WY 82930-8722
Phone 307-679-7105
Mailing address
322 Gannett DrEvanston, WY 82930-8722
Phone 307-679-7105
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