Tanisha Tiana Clark
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 StWallingford, CT 06492-3818
Phone: (203) 697-2983
Show map & directions
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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 number | 1871095935 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | March 5, 2018 |
| Last updated in NPPES | February 15, 2021 |
| Certification date | February 15, 2021 |
Other providers in Wallingford
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MS. Alicia Anne Eldridge
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Seung Jun Jang
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Robert Anthony Violette
181 N Main St, Wallingford, CT 06492-3711 · (203) 684-5135
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Reagan Wentzell
49 High St, Wallingford, CT 06492-3120 · (203) 317-9725