Individual
ALICIA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS/CCC-SLP
Contact information
Practice address
701 MADISON AVE, MADISON, WV 25130-1669
(304) 369-5719
(304) 369-2930
Mailing address
701 MADISON AVE, MADISON, WV 25130-1669
(304) 369-5719
(304) 369-2930
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1219
WV
235Z00000X
Speech-Language Pathologist
SLP-1219
WV
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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