Doctor Name: | MISS GAIL ELIZABETH CLARK |
NPI Number: | 1457506537 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA/SLP |
License Number: | 008512-1 |
Business Practice Address: | 6116 Marathon Pkwy Douglaston, NY - 113622043 |
Business Phone Number: | 9176923568 |
Business Fax Number: | |
Mailing Address: | 6116 Marathon Pkwy, DOUGLASTON |
State: | NY |
Postal Code: | 113622043 |
Phone Number: | 9176923568 |
Fax Number: | |
NPI Enumeration Date: | 11/17/2008 |
NPI Last Update Date: | 11/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 008512-1 |
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 |