Individual
AMBER CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
60 W CALVARY DR, LEBANON, KY 40033-8421
(270) 779-4143
Mailing address
60 W CALVARY DR, LEBANON, KY 40033-8421
(270) 779-4143
(859) 336-0380
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
12-001
KY
235Z00000X
Speech-Language Pathologist
Primary
140756
KY
Other
Enumeration date
05/23/2012
Last updated
06/10/2020
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