Individual
MICHELLE GRACE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MHS, CCC-SLP
Contact information
Practice address
640 NW JEFFERSON ST, GRAIN VALLEY, MO 64029-8278
(816) 847-8279
Mailing address
620 NW YENNIE ST, APT. 314, GRAIN VALLEY, MO 64029-9362
(573) 289-5040
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2014020191
MO
Other
Enumeration date
09/23/2014
Last updated
09/23/2014
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