Doctor Name: | MS. LAURA A CLARK |
NPI Number: | 1407012412 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC/SLP |
License Number: | 010292-1 |
Business Practice Address: | 25 High School Dr Penfield, NY - 145261422 |
Business Phone Number: | 5852496817 |
Business Fax Number: | 5852482810 |
Mailing Address: | Po Box 900, PENFIELD |
State: | NY |
Postal Code: | 145260900 |
Phone Number: | 5852496817 |
Fax Number: | 5852482810 |
NPI Enumeration Date: | 07/30/2008 |
NPI Last Update Date: | 12/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 010292-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
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 |