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Individual

SHANNON LORRAINE CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
350 N CENTER ST, LOWELL, MI 49331-1212
(616) 897-8473
Mailing address
5333 MAPLE HILL AVE SE, ADA, MI 49301-7717
(616) 828-3879

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101006594
MI

Other

Enumeration date
09/21/2016
Last updated
06/25/2024
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