Individual
ANGEL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
6035 PEACHTREE RD STE C120, DORAVILLE, GA 30360-3234
(678) 514-3270
Mailing address
1085 HUNTERS CROSSING LN, MONROE, GA 30656-4857
(678) 699-7929
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP011104
GA
Other
Enumeration date
07/30/2020
Last updated
07/30/2020
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