Individual
HEATHER M CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, CCC-SLP
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
8601
MN
235Z00000X
Speech-Language Pathologist
3963
NC
235Z00000X
Speech-Language Pathologist
Primary
8601
MN
Other
Enumeration date
07/28/2006
Last updated
08/27/2020
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