Individual
MRS. CLARA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
455 DOUGLAS AVE, PROVIDENCE, RI 02908-2542
(401) 553-8600
Mailing address
115 MAIN AVE, WARWICK, RI 02886-3631
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP00991
RI
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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