Search › Illinois › 103TS0200X
Mandi Clark, NCSP
NPI 1093239758 · on the registry since 2017 · sole proprietor
Practice
- Address
- 310 S Coal St
Colchester, IL 62326 - Phone
- (309) 776-3002
- Fax
- (309) 776-3002
- Clinicians at this address
- 2
Additional practice sites
- 310 S Coal St, Colchester, IL
Registry record
- Primary taxonomy
- 103TS0200X
103TS0200X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2018-03-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois