Individual
ABBIE LEANN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10640 N RIVERSIDE DR STE 200, FORT WORTH, TX 76244-9506
(817) 431-9000
(817) 796-2781
Mailing address
10640 N RIVERSIDE DR STE 200, FORT WORTH, TX 76244-9506
(817) 431-9000
(817) 796-2781
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
120373
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120373
SPEECH THERAPY LICENSE
TX
Enumeration date
08/11/2020
Last updated
07/12/2023
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