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Contact Information

MICHELLE CLARK, RTT PRACTITIONER
596 SILVER BEACH DR
JEROME, ID83338-6416
 Phone: 385-279-1039
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Health & Wellness Coach

171400000X
Indicates primary specialty

NPI Profile & details for MICHELLE CLARK · (Female)

NPI # 1083411151
Status Active
Credentials RTT PRACTITIONER
Entity Individual
Enumeration date 02/26/2025
Last updated 03/03/2025 - More than a year ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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