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1487198255
MONIQUE R CLARK
SOUTHFIELD, MI
NPI
1487198255
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MI 4704262087)
Enumeration Date
2016-12-13
Last Update Date
2016-12-13
Business Address
Ms. MONIQUE R CLARK FNP
20755 GREENFIELD RD SUITE 100
SOUTHFIELD, MI 48075-5403
Phone number: 248-557-0507
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Mailing Address
Ms. MONIQUE R CLARK FNP
26520 MEADOWOOD CT N
LATHRUP VILLAGE, MI 48076-4650
Phone number: 313-595-2218
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