Provider Demographics
NPI:1912726167
Name:RAMSEY-CLARK, KOREN (MS)
Entity type:Individual
Prefix:MRS
First Name:KOREN
Middle Name:
Last Name:RAMSEY-CLARK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W 2ND ST UNIT 1112
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48068-7047
Mailing Address - Country:US
Mailing Address - Phone:248-716-0363
Mailing Address - Fax:
Practice Address - Street 1:200 W 2ND ST UNIT 1112
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48068-7047
Practice Address - Country:US
Practice Address - Phone:248-571-7580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-05
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education