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Crystal Clark
NPI 1467014894 · on the registry since 2019 · sole proprietor
Practice
- Address
- 153 Brambury Dr Apt D
Rochester, NY 14621 - Phone
- (404) 621-2852
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 372600000X
372600000X
- Also registered as
- 376K00000X
372500000X - Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2019-07-06
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 New York