Individual
AUDREY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4501 DUDMAR DR, AUSTIN, TX 78735-6913
(512) 892-1131
Mailing address
7001 BLESSING AVE APT B, AUSTIN, TX 78752-3336
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
113061
TX
Other
Enumeration date
08/29/2018
Last updated
08/29/2018
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