Individual
ANGELA C CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
6712 FAIRVIEW TER, BRADENTON, FL 34203-8854
(863) 244-4574
Mailing address
6712 FAIRVIEW TER, BRADENTON, FL 34203-8854
(863) 244-4574
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
SA5772
FL
Other
Enumeration date
06/02/2009
Last updated
06/23/2023
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