IndividualActive
Deserie Clack-Wilson
NPI 1447869029 · Community Health Worker · Bridgeport, CT
Provider details
- NPI number
- 1447869029
- Entity type
- Individual
- Primary specialty
- Community Health WorkerOther Service Providers
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Practice location
1000 Lafayette Blvd Ste 1128
Bridgeport, CT 06604-4725
Phone: (203) 683-3428
Fax: (203) 683-5901
Approximate (ZIP-level) locationGet directions
Mailing address
1000 Lafayette Blvd Ste 1128
Bridgeport, CT 06604-4725
Registry dates
- Enumerated
- 2020-07-29
- Last updated
- 2020-07-29
- Certified
- 2020-07-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.