Jessica Latisha Clarke
Home Health Aide in Orlando, FL. Individual provider (NPI-1).
NPI number1932790078
StatusActive
Last updated in NPPESJan 28, 2022
Details
- NPI
- 1932790078
- Entity type
- Individual (NPI-1)
- Name
- Jessica Latisha Clarke
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 1, 2021
- Certification date
- Jan 22, 2022
- Last updated
- Jan 28, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 374U00000X | Home Health Aide | – | – | Yes |
| 372600000X | Adult Companion | – | – | |
| 373H00000X | Day Training/Habilitation Specialist | – | – | |
| 376J00000X | Homemaker | – | – |
Practice location
2441 Pulaski AveOrlando, FL 32818-3944
Phone 407-455-0311
Mailing address
Po Box 91032Lakeland, FL 33804-1032
Phone 407-455-0311
Other practice locations
4240 Summer Landing Dr Apt 102
Lakeland, FL 33810-3849
Lakeland, FL 33810-3849
Phone 407-455-0311
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