Individual
MRS. MERRY LACY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC/SLP
Contact information
Practice address
5422 SUPERIOR DR, BATON ROUGE, LA 70816-6063
(225) 802-7748
Mailing address
4025 OVERLOOK POINT CT, BATON ROUGE, LA 70817-1620
(432) 413-8386
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7028
LA
235Z00000X
Speech-Language Pathologist
SL009003
PA
Other
Enumeration date
11/05/2008
Last updated
10/02/2013
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