Individual
SHANNON CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6705 W HIGHWAY 290 STE 607-107, AUSTIN, TX 78735-8400
(512) 679-6164
Mailing address
6705 W HIGHWAY 290 STE 607-107, AUSTIN, TX 78735-8400
(512) 679-6164
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1192217
TX
Other
Enumeration date
03/15/2025
Last updated
03/15/2025
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