Individual
DANIELLE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2810 FRANK SCOTT PARKWAY WEST, BELLEVILLE, IL 62223-5007
(618) 234-9705
Mailing address
2810 FRANK SCOTT PARKWAY WEST, BELLEVILLE, IL 62223-5007
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242003637
IL
Other
Enumeration date
09/15/2015
Last updated
09/15/2015
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