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Individual

MRS. BRENDA S CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
7501 OTOE PL, LINCOLN, NE 68506-3636
(402) 486-6649
(402) 484-6413
Mailing address
7501 OTOE PL, LINCOLN, NE 68506-3636
(402) 486-6649
(402) 484-6413

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
924
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100251395-00
NE
Enumeration date
06/12/2008
Last updated
06/12/2008
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