MRS. MARVELOUS CLARK (NPI# 1700175882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700175882 |
| Entity Type | Individual |
| Full Name | MRS. MARVELOUS CLARK |
| Practice Address |
5923 Theodosia Ave Saint Louis MO 63112-3622 |
| Practice Telephone | 3143835185 |
| Practice Fax Number | 3143835185 |
| Mailing Telephone | 3143835185 |
| Mailing Fax Number | 3143835185 |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2011-03-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171W00000X | Contractor | Other Service Providers |
| Street Address |
5923 THEODOSIA AVE |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63112-3622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851932990 | Bobbie J. Harrington | Technician | 5626 Julian Avenue, St. Louis, MO 63112 | 2019-09-30 |
| 1861901480 | Christina Cummings | Counselor | 5387 Pershing Ave., Apt. A, St. Louis, MO 63112 | 2017-09-26 |
| 1326457177 | Clare Marie Salley | Speech-Language Pathologist | 5673 Waterman Blvd, Unit 31, St Louis, MO 63112 | 2014-08-06 |
| 1386999324 | Family Love Adult Health Care Center, LLC | Clinic/Center | 286 Debaliviere Avenue, St. Louis, MO 63112 | 2012-07-16 |
| 1003133893 | William Richard Humphrey II | Chiropractor | 5615 Pershing, Suite 22, St. Louis, MO 63112 | 2010-05-03 |
| 1558688408 | Courtney Lynne Luster | Counselor | 5647 Delmar Blvd Ste 226, Saint Louis, MO 63112 | 2010-04-30 |
| 1134446602 | Donald Trevor Cross | Psychologist | #7 Beverly Place, St. Louis, MO 63112 | 2010-04-23 |
| 1649507328 | Vikram Choudhary | Prosthetist | 6126 Washington Blvd, # 201, St. Louis, MO 63112 | 2009-11-17 |
| 1992930325 | Kelly Brook Hogan | Social Worker | 5355 Delmar, Saint Louis, MO 63112 | 2009-05-29 |
| 1942449194 | Annie Malone Children and Family Service Center | Respite Care | 5355 Page Avenue, St. Louis, MO 63112 | 2009-02-11 |
| Find all providers in zip 63112 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609328996 | Gina Lagarce | Contractor | 801 N. 11th Street, St. Louis Public Schools, Saint Louis, MO 63107 | 2016-11-02 |
| 1063967339 | Stephanie Kennedy | Contractor | 5890 Kennerly Ave, Saint Louis, MO 63112-3822 | 2016-08-16 |
| 1407200728 | Desiray Taylor | Contractor | 2318 Woodson Rd, Unit 142324, Saint Louis, MO 63114-5544 | 2016-04-22 |
| 1427422336 | Northlight Development Lp | Contractor | 3414 Hawthorne Blvd, Saint Louis, MO 63104-1623 | 2015-11-17 |
| 1497148845 | Walter Kopecky Jr. | Contractor | 342 Royal Valley Dr, Saint Louis, MO 63141-6653 | 2015-03-10 |
| 1033513692 | Jack Sailor | Contractor | 2206 Lucas Ave Unit 508, Saint Louis, MO 63103-1555 | 2014-10-10 |
| 1649696386 | North American Rural Health Services, Inc. | Contractor | 9245 Watson Industrial Park, Saint Louis, MO 63126-1518 | 2014-03-05 |
| 1609207893 | Shanda Bonner | Contractor | 1504 Park Way Dr, Saint Louis, MO 63130-1245 | 2013-12-12 |
| 1043579063 | Tonia Denise Ambus | Contractor | 10262 Page Ave, Saint Louis, MO 63132-1322 | 2012-05-10 |
| 1720214760 | Especial Needs, LLC | Contractor | 1850 Borman Court, Saint Louis, MO 63146 | 2009-06-04 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63112 |
Please comment or provide details below to improve the information on MRS. MARVELOUS CLARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.