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1346866563
JENDAYA M CLARK
ROCKFORD, IL
NPI
1346866563
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101Y00000X Counselor
(Licence: IL 180.012915)
Enumeration Date
2020-06-23
Last Update Date
2020-06-23
Business Address
JENDAYA M CLARK
1201 CYPRESS TER
ROCKFORD, IL 61102-3375
Phone number: 815-519-8548
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Mailing Address
JENDAYA M CLARK
PO BOX 341
ROCKFORD, IL 61105-0341
Phone number: 815-519-8548
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