Clark, Latisha
Clark, Latisha is an sole proprietor health care provider with primary practice located at 8109 Blackgum Ct , Indianapolis IN 46236-8260. She recently has only one registered license in Agencies / Day Training, Developmentally Disabled Services, which is considered as her primary health care specialty. Clark, Latisha can be contacted via phone (317) 658-5177.Contact Information
Primary practice address
8109 Blackgum Ct
Indianapolis IN 46236-8260
Phone: (317) 658-5177
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Agencies / Day Training, Developmentally Disabled Services | 251C00000X |
Profile Details
| NPI number | 1932714318 |
|---|---|
| LBN Legal business name | Clark, Latisha |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 11th, 2020 |
| Last updated | Jun 30th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932714318 | NPPES |
| Indiana | Other | 00000000 | LATISHA |
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