Individual
PROF. JACKIE LEAH CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
601 S TOOL DR, TOOL, TX 75143-1959
(903) 432-1932
(903) 432-0520
Mailing address
5038 CREEKWOOD DR, FLOWER MOUND, TX 75028-1913
(972) 539-8558
(214) 905-3022
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
66993
CSHCN
TX
Enumeration date
06/08/2005
Last updated
10/28/2020
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