Individual
MRS. ELIZABETH ANN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
80 OLD NEW SALEM RD, UNIONTOWN, PA 15401-8902
(724) 438-8416
Mailing address
375 N MORELAND ST, BOX 245, BOBTOWN, PA 15315
(724) 839-7478
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL006098L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001886881
—
PA
Enumeration date
04/18/2007
Last updated
07/08/2007
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