Individual
CLARISSA MCCORMICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 CHERRY LN, GREAT BEND, KS 67530-3152
(316) 209-9019
Mailing address
766 W BARTON COUNTY RD, GREAT BEND, KS 67530-9342
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2620
KS
Other
Enumeration date
01/15/2007
Last updated
07/08/2007
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