Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DESERIE ALINE CLACK-WILSON
ActiveCommunity Health Worker · BRIDGEPORT, CT
Registration Details
- NPI Number
- 1447869029
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 29, 2020 (5.7576573762004 yrs)
- Last Updated
- Jul 29, 2020
Practice Information
- Address
-
1000 LAFAYETTE BLVD STE 1128BRIDGEPORT, CT, 066044725Browse CT providers · Browse ZIP 06604
- Phone
- 2036833428
- Fax
- 2036835901
- Primary Specialty
-
Community Health Worker
172V00000X
Other Community Health Worker Providers in BRIDGEPORT, CT
| Name | Credential | NPI |
|---|---|---|
| MS. KIM MIMS | — | 1215162425 |
| IDA R PRATT | CHW | 1780024943 |
| MR. JEROME C HAILEY | — | 1043626997 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.