Individual
MISS DIANA MARCELA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., SLP
Contact information
Practice address
4300 LONG BEACH BLVD STE 700, LONG BEACH, CA 90807-2000
(818) 894-2273
(818) 357-2505
Mailing address
6546 E CHANNEL DR, HERNANDO, FL 34442-3708
(786) 246-5967
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
144.0134728
VT
235Z00000X
Speech-Language Pathologist
Primary
19290
CA
235Z00000X
Speech-Language Pathologist
SA8620
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
890986500
—
FL
Enumeration date
07/14/2006
Last updated
05/14/2026
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