Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tanisha Tiana Clark

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1871095935

Tanisha Tiana Clark is a Student in an Organized Health Care Education/Training Program in Wallingford, Connecticut. Practices as a sole proprietor and works from 2 locations. Licensed in Connecticut.

Licensed in
CT
In the registry since
2018
Specialties on file
3

Practice location Address checks out

333 Christian St
Wallingford, CT 06492-3818
Phone: (203) 697-2983
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 541 Main St, New London, NH 03257-7818 — (603) 526-3400

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 54.001470 (CT)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Athletic Trainer Taxonomy 2255A2300X

Record details

NPI number1871095935
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 5, 2018
Last updated in NPPESFebruary 15, 2021
Certification dateFebruary 15, 2021

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