Individual provider · Type 1 NPI

Maryelizabeth Clark, BS

Student in an Organized Health Care Education/Training Program · Brockton, MA

NPI number 1821321795 Active

Practice location

1115 W Chestnut St
Brockton, MA 02301-7501

Call (508) 559-0473 Map

Fax (508) 427-5361

Mailing address

16 Pitas Ave
South Attleboro, MA 02703-7119

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1821321795

Maryelizabeth Clark, BS's National Provider Identifier is 1821321795, issued on Sep 10, 2009. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Brockton, MA. The record was last updated on Sep 10, 2009.