Provider Demographics
NPI:1982451399
Name:CRICK, CLARA SAMANTHA (CD)
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:SAMANTHA
Last Name:CRICK
Suffix:
Gender:F
Credentials:CD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7980 MAXTOWN RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-9004
Mailing Address - Country:US
Mailing Address - Phone:502-552-2601
Mailing Address - Fax:
Practice Address - Street 1:7980 MAXTOWN RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-9004
Practice Address - Country:US
Practice Address - Phone:502-552-2601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula