Individual provider · Type 1 NPI
Letricia Lenise Clark, NURSE PRACTITIONER
Psychiatric/Mental Health Nurse Practitioner · Pontiac, MI
NPI number
1255844023
Active
Practice location
461 W Huron St Ste 103
Pontiac, MI 48341-1601
Fax (248) 724-6800
Mailing address
PO Box 430150
Pontiac, MI 48343-0150
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 4704261814 (MI) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
2 other providers at this address
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About NPI 1255844023
Letricia Lenise Clark, NURSE PRACTITIONER's National Provider Identifier is 1255844023, issued on Nov 14, 2017. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Pontiac, MI. The record was last updated on Oct 20, 2026.