Individual
JANE CLARKSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1841 VANDALIA ST, COLLINSVILLE, IL 62234-4854
(618) 346-6301
Mailing address
504 VALLEY VIEW DR, EDWARDSVILLE, IL 62025-3318
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
12/06/2017
Last updated
12/06/2017
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