Individual
CHRISTIE B CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSP, CCC-SLP
Contact information
Practice address
787 E LONG BAY DR, INMAN, SC 29349-5916
(864) 308-8004
(864) 345-8446
Mailing address
787 E LONG BAY DR, INMAN, SC 29349-5916
(864) 308-8004
(864) 345-8446
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3753
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA1124
—
SC
Enumeration date
08/05/2010
Last updated
08/23/2013
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