RUSSELL CLARK
Peer Specialist
Active
Individual
NPI: 1659111508
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | No | - |
| Community Health Worker | 172V00000X | No | - |
| Peer Specialist | 175T00000X | Yes | - |
Frequently Asked Questions
NPI 1659111508 is the National Provider Identifier for RUSSELL CLARK, a Peer Specialist provider located in Saint Louis, MO. This NPI was enumerated on May 29, 2024.
RUSSELL CLARK practices at 3649 MERAMEC ST, Saint Louis, MO 63116.
Quick Facts
- NPI
- 1659111508
- Type
- Individual
- Enumerated
- May 29, 2024
- Last Updated
- May 29, 2024
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