Individual
MRS. ALISON ILENE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1220 E 2ND AVE, MONMOUTH, IL 61462-2404
(309) 734-7902
(309) 734-7114
Mailing address
114 S 4TH ST, MONMOUTH, IL 61462-1812
(309) 734-7308
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
01/30/2008
Last updated
01/30/2008
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