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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

TANISHA TIANA CLARK

Active Sole Proprietor

TANISHA TIANA CLARK is a Athletic Trainer healthcare provider located in WALLINGFORD, Connecticut. NPI 1871095935 is currently active in the NPPES registry. Verify at CMS.

Athletic Trainer · WALLINGFORD, CT

Registration Details

NPI Number
1871095935
Provider Type
Individual
Gender
Female
NPI Issued
Mar 5, 2018 (8.4640954213408 yrs)
Last Updated
Feb 15, 2021
License
54.001470 (CT)
Sole Proprietor
Yes

Practice Information

Address
333 CHRISTIAN ST
WALLINGFORD, CT, 064923818
Browse CT providers · Browse ZIP 06492
Phone
2036972983
Primary Specialty
Athletic Trainer
2255A2300X
Additional Specialty
Athletic Trainer
Additional Specialty
Athletic Trainer

Other Athletic Trainer Providers in WALLINGFORD, CT

Name Credential NPI
MR. MARC ROBERT ACETO A.T.,C. 1184605024
DR. SHARON PATRICIA MISASI PHD 1518936962
BRIAN EDWARD HOLLOWAY JR. ATC 1083707806
EMILY PINDAR ATC 1184717928
MR. MATTHEW BRIAN PENDLETON MED., ATC 1538252366
MR. PETER E IVES II ATHLETIC TRAINER 1023233160
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.