Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
LATISHA CLARK
Active Sole ProprietorLATISHA CLARK is a Behavioral Health, Residential healthcare provider located in INDIANAPOLIS, Indiana. NPI 1932714318 is currently active in the NPPES registry. Verify at CMS.
Behavioral Health, Residential · INDIANAPOLIS, IN
Registration Details
- NPI Number
- 1932714318
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 11, 2020 (5.957667545171 yrs)
- Last Updated
- Jun 30, 2022
- Sole Proprietor
- Yes
Practice Information
- Address
-
8109 BLACKGUM CTINDIANAPOLIS, IN, 462368260Browse IN providers · Browse ZIP 46236
- Phone
- 3176585177
- Primary Specialty
-
Behavioral Health, Residential
251C00000X
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.