National Provider Identifier

Kristin Marie Clark, MS SPECIAL EDUCATION

Kristin Marie Clark, MS SPECIAL EDUCATION is listed in the NPPES registry with a primary specialty of Specialist in Rochester, NY and a listed phone number of (585) 467-4567.

NPI 1407106032Rochester, NYSpecialist

Profile Overview

NPI
1407106032
Provider Type
Individual
Primary Specialty
Specialist
Enumeration Date
September 11, 2012
Last Updated
September 11, 2012

Practice Location

  • 41 Colebrook Dr
  • Rochester, NY 14617-2211

Phone: (585) 467-4567

Mailing Address

  • 17 Varden St
  • Rochester, NY 14609-4804

Specialties

  • Specialist (174400000X)
Full Record
NPI
1407106032
Entity Type
Individual
Last Name
Clark
First Name
Kristin
Middle Name
Marie
Name Prefix
Mrs.
Credential
MS SPECIAL EDUCATION
Mailing Street Address
17 Varden St
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14609-4804
Mailing Country
US
Practice Street Address
41 Colebrook Dr
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14617-2211
Practice Country
US
Practice Phone
(585) 467-4567
Practice Fax
(585) 467-6973
Enumeration Date
September 11, 2012
Last Updated
September 11, 2012
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Specialist (174400000X)