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

SHANELL CLARK

Active Sole Proprietor

SHANELL CLARK is a 376G00000X healthcare provider located in OAK PARK, Michigan. NPI 1972958106 is currently active in the NPPES registry. Verify at CMS.

376G00000X · OAK PARK, MI

Registration Details

NPI Number
1972958106
Provider Type
Individual
Gender
Female
NPI Issued
Apr 25, 2016 (10.314296171304 yrs)
Last Updated
Apr 25, 2016
Sole Proprietor
Yes

Practice Information

Address
21820 BEVERLY ST
OAK PARK, MI, 482372503
Browse MI providers · Browse ZIP 48237
Phone
2482346150
Primary Specialty
376G00000X
376G00000X
Additional Specialty
Chore Provider
Additional Specialty
Day Training/Habilitation
Additional Specialty
376G00000X

Other 376G00000X Providers in OAK PARK, MI

Name Credential NPI
LARESE WOOD HEALTH CARE PROVIDER 1457877110
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.