Individual
KIMBERLY D CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
1524 LEXINGTON ROAD, CLOVIS, NM 88101-6846
(575) 219-9354
Mailing address
1524 LEXINGTON RD, CLOVIS, NM 88101-4418
(575) 219-9354
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
235Z00000X
Speech-Language Pathologist
Primary
105425
TX
Other
Enumeration date
09/09/2011
Last updated
04/17/2019
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