Individual
CARMEN BETH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
29 N ACADEMY ST, GREENVILLE, SC 29601-2629
(864) 331-1350
Mailing address
1 INDEPENDENCE PT, STE 212, GREENVILLE, SC 29615-4545
(864) 797-6307
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1058
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA0328
—
SC
Enumeration date
07/26/2006
Last updated
11/20/2013
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