Organization
AMY S. CLARK, SPEECH LANGUAGE PATHOLOGIST,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY S. CLARK (OWNER/PROVIDER)
(719) 369-6862
Entity
Organization
Contact information
Practice address
129 COLORADO AVENUE, PUEBLO, CO 81004
(719) 369-6862
(719) 941-7314
Mailing address
129 COLORADO AVENUE, PUEBLO, CO 81004
(719) 369-6862
(719) 941-7314
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
95037071
—
CO
Enumeration date
10/12/2020
Last updated
02/24/2023
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