Individual
MRS. SHANNON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S
Contact information
Practice address
7440 W COLLEGE DR, SUITE 200, PALOS HEIGHTS, IL 60463-1375
(708) 448-7423
(708) 448-7843
Mailing address
25225 SHANNON DR, MANHATTAN, IL 60442-6203
(708) 448-7423
(708) 448-7843
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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