Provider Demographics
NPI:1780242453
Name:CLARK, SABRINA PAIGE
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:PAIGE
Last Name:CLARK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 PARKS HIGHWAY, SUITE 101
Mailing Address - Street 2:
Mailing Address - City:WASILA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-8298
Mailing Address - Country:US
Mailing Address - Phone:435-586-6654
Mailing Address - Fax:435-586-6865
Practice Address - Street 1:1365 PARKS HIGHWAY, SUITE 101
Practice Address - Street 2:
Practice Address - City:WASILA
Practice Address - State:AK
Practice Address - Zip Code:99654-8298
Practice Address - Country:US
Practice Address - Phone:435-586-6654
Practice Address - Fax:435-586-6865
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No104100000XBehavioral Health & Social Service ProvidersSocial Worker