Doctor Name: | CHARLES SYLVESTER CLARKE |
NPI Number: | 1861653933 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A |
License Number: | 4315 |
Business Practice Address: | 4033 Whispering Pines Rd S Augusta, GA - 309069138 |
Business Phone Number: | 7067968743 |
Business Fax Number: | |
Mailing Address: | 4033 Whispering Pines Rd S, AUGUSTA |
State: | GA |
Postal Code: | 309069138 |
Phone Number: | 7067968743 |
Fax Number: | |
NPI Enumeration Date: | 06/22/2008 |
NPI Last Update Date: | 06/22/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 4315 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
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 |