National Provider Identifier

Crystal Clark

Crystal Clark is listed in the NPPES registry with a primary specialty of Adult Companion in Rochester, NY and a listed phone number of (404) 621-2852.

NPI 1467014894Rochester, NYAdult Companion

Profile Overview

NPI
1467014894
Provider Type
Individual
Primary Specialty
Adult Companion
Enumeration Date
July 06, 2019
Last Updated
July 06, 2019

Practice Location

  • 153 Brambury Dr Apt D
  • Rochester, NY 14621-1820

Phone: (404) 621-2852

Mailing Address

  • PO Box 64283
  • Rochester, NY 14624-6683

Specialties

  • Adult Companion (372600000X)
  • Chore Provider (372500000X)
  • Nurse's Aide (376K00000X)
Full Record
NPI
1467014894
Entity Type
Individual
Last Name
Clark
First Name
Crystal
Mailing Street Address
PO Box 64283
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14624-6683
Mailing Country
US
Mailing Phone
(404) 321-2852
Practice Street Address
153 Brambury Dr Apt D
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14621-1820
Practice Country
US
Practice Phone
(404) 621-2852
Enumeration Date
July 06, 2019
Last Updated
July 06, 2019
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Adult Companion (372600000X), Chore Provider (372500000X), Nurse's Aide (376K00000X)