Doctor Name: | ALLISON CLARK |
NPI Number: | 1992118350 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CF-SLP |
License Number: | SZ 6654 |
Business Practice Address: | 1069 John Sims Pkwy E Suite Number 4 Niceville, FL - 325782767 |
Business Phone Number: | 8508973013 |
Business Fax Number: | 8508970149 |
Mailing Address: | 1069 John Sims Pkwy E, Suite Number 4 NICEVILLE |
State: | FL |
Postal Code: | 325782767 |
Phone Number: | 8508973013 |
Fax Number: | 8508970149 |
NPI Enumeration Date: | 06/03/2014 |
NPI Last Update Date: | 06/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SZ 6654 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
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 |