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Contact Information

NICOLE M CLARK, M.ED
6611 SW 81 STREET
GAINESVILLE, FL32608
 Phone: 352-727-8321
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for NICOLE M CLARK · (Female)

NPI Number 1447405766
Status Active
Credentials M.ED
Entity Individual
Enumeration date 12/01/2008
Last updated 04/15/2019 - About 7 years ago
Sole proprietor 1 Yes
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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