Individual
MRS. JESSICA ANN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC-SLP
Contact information
Practice address
7424 SHADELAND STATION WAY, INDIANAPOLIS, IN 46256-3925
(317) 288-7606
(317) 288-7607
Mailing address
5818 STONE PINE TRL, CARMEL, IN 46033-8254
(317) 625-3679
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004331A
IN
Other
Enumeration date
06/06/2012
Last updated
06/06/2012
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