Individual
ANDREA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
765 YELLOWJACKET LN, CLINTON, AR 72031-6836
(501) 745-6000
Mailing address
27 GREYSTONE DR, GREENBRIER, AR 72058-9382
(501) 230-6290
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2480
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164773721
—
AR
Enumeration date
09/24/2007
Last updated
08/21/2024
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