Doctor Name: | CLARE BLAKE CLARK |
NPI Number: | 1376675710 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | KY-2643 |
Business Practice Address: | 3740 Jenn Ln Paducah, KY - 420015892 |
Business Phone Number: | 2705341860 |
Business Fax Number: | 2705341860 |
Mailing Address: | 3740 Jenn Ln, PADUCAH |
State: | KY |
Postal Code: | 420015892 |
Phone Number: | 2705341860 |
Fax Number: | 2705341860 |
NPI Enumeration Date: | 03/12/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | KY-2643 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
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 |