Individual
KIMBERLY RENEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
14715 BRISTOW RD, MANASSAS, VA 20112-3945
(703) 791-7200
Mailing address
4106 ASHMERE CIR, DUMFRIES, VA 22025-1516
(571) 435-6639
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2204001621
VA
Other
Enumeration date
06/17/2025
Last updated
06/17/2025
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