Individual
HAILEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1790 S FAIRVIEW AVE, DECATUR, IL 62521-4010
(217) 429-2551
Mailing address
953 W FRANK DR, DECATUR, IL 62526-1232
(217) 454-4478
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
04/25/2021
Last updated
04/25/2021
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