| Doctor Name: | AMBER S CLARK |
| NPI Number: | 1609011592 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. CCC-SLP |
| License Number: | 13019 |
| Business Practice Address: | 898 Sw Fourth Ave. Ontario, ID - 979142693 |
| Business Phone Number: | 5418817330 |
| Business Fax Number: | |
| Mailing Address: | 290 N Higbee Ave, IDAHO FALLS |
| State: | ID |
| Postal Code: | 834012554 |
| Phone Number: | 2088906841 |
| Fax Number: | |
| NPI Enumeration Date: | 12/08/2008 |
| NPI Last Update Date: | 02/02/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 13019 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| 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 |