Latisha Clark
Latisha Clark is a Developmentally Disabled Services Day Training Agency in Indianapolis, Indiana. Practices as a sole proprietor. Registered with an NPI since 2020.
- In the registry since
- 2020
Practice location Address checks out
8109 Blackgum CtIndianapolis, IN 46236-8260
Phone: (317) 658-5177
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Specialties & licences
| Developmentally Disabled Services Day Training Agency (primary) | Taxonomy 251C00000X |
|---|
Record details
| NPI number | 1932714318 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | September 11, 2020 |
| Last updated in NPPES | June 30, 2022 |
| Certification date | June 30, 2022 |
| Mailing address | 8109 Blackgum Ct, Indianapolis, IN 46236-8260 |
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