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Individual

MRS. STACI M CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., CCC-SLP

Contact information

Practice address
355 OAK GROVE RD, SPARTANBURG, SC 29301-2537
(864) 595-4225
(864) 595-4821
Mailing address
200 BROUGHTON DR, GREENVILLE, SC 29609-3841
(864) 233-7905
(864) 233-7905

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3567
SC

Other

Enumeration date
07/18/2006
Last updated
07/08/2007
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