Individual
SHANNON CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSE
Contact information
Practice address
200 GENERAL ST, BATESVILLE, AR 72501-9407
(870) 793-3200
Mailing address
200 GENERAL STREET, BATESVILLE, AR 72501
(870) 793-3200
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
05/29/2012
Last updated
05/29/2012
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