Search › Georgia › 363LF0000X
Telisha Clark
NPI 1659281608 · on the registry since 2026 · sole proprietor
Practice
- Address
- 475 Hilo Rd
Fayetteville, GA 30215 - Phone
- (678) 778-1224
Registry record
- Primary taxonomy
- 363LF0000X
363LF0000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2026-09-10
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 Georgia