Individual
DANITA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
250 GEORGIA AVE SE, ATLANTA, GA 30312-3046
(985) 774-6262
Mailing address
1825 PARKER RD SE APT 510, CONYERS, GA 30094-2663
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
02/14/2019
Last updated
02/14/2019
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