Individual
MRS. STEPHANIE K CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M SP ED
Contact information
Practice address
1501 BRECKENRIDGE ST, OWENSBORO, KY 42303-1054
(270) 852-5553
(270) 852-2941
Mailing address
1501 BRECKENRIDGE ST, OWENSBORO, KY 42303-1054
(270) 852-5553
(270) 852-2941
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/08/2013
Last updated
06/15/2016
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