Individual
JESSICA ANN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
3101 E STATE ST, SUITE 2108, EAGLE, ID 83616-6232
(208) 489-4975
(208) 489-4089
Mailing address
3101 E STATE ST, SUITE 2108, EAGLE, ID 83616-6232
(208) 385-3480
(208) 385-3481
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AUD-2269
ID
Other
Enumeration date
07/20/2012
Last updated
02/27/2018
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