| Doctor Name: | MELISSA CLARK |
| NPI Number: | 1376672246 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MCD, CCC-SLP |
| License Number: | 4226 |
| Business Practice Address: | 1111 N Kentucky Ave West Plains, MO - 657752028 |
| Business Phone Number: | 4172575959 |
| Business Fax Number: | 4172575814 |
| Mailing Address: | 1111 N Kentucky Ave, WEST PLAINS |
| State: | MO |
| Postal Code: | 657752028 |
| Phone Number: | 4172575959 |
| Fax Number: | 4172575814 |
| NPI Enumeration Date: | 03/05/2007 |
| NPI Last Update Date: | 09/30/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 4226 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TN |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |