Individual
MS. MISTY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
401 INDIANA AVE, MAYFIELD, KY 42066-1766
(270) 247-0200
Mailing address
1701 KANDI KAY LN, MURRAY, KY 42071-4440
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
172845
KY
Other
Enumeration date
12/30/2017
Last updated
12/30/2017
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