DEMETRIUS CLARK

BATON ROUGE, LA
NPI1447772546
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies106S00000X Behavior Technician
Enumeration Date2017-07-10
Last Update Date2022-07-21
Business Address
DEMETRIUS CLARK
6044 INGRAM DR
BATON ROUGE, LA 70812-2327
Phone number: 225-315-2104
Mailing Address
DEMETRIUS CLARK
6044 INGRAM DR
BATON ROUGE, LA 70812-2327
Phone number: 225-315-2104
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