Individual
ALICIA MARY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15800 BEACH WALK BLVD STE 1001, FORT MYERS, FL 33908-3388
(239) 349-3769
Mailing address
14721 EDEN ST, FORT MYERS, FL 33908-1642
(239) 834-7245
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA3674
FL
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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