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1164168308
NICOLE LEE CLARK
WICHITA FALLS, TX
NPI
1164168308
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
222Q00000X Developmental Therapist
Enumeration Date
2022-05-10
Last Update Date
2022-05-10
Business Address
NICOLE LEE CLARK
1709 10TH ST
WICHITA FALLS, TX 76301-5010
Phone number: 940-257-8358
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Mailing Address
NICOLE LEE CLARK
PO BOX 8266
WICHITA FALLS, TX 76307-8266
Phone number: 940-257-8358
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