| NPI | 1275791949 |
|---|---|
| Other Name | DIANE CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 1898) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 91681) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2008-05-29 |