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Individual

DEANNA CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS,CCC-SLP

Contact information

Practice address
4021 IONA CIR, ANCHORAGE, AK 99507-3341
(907) 344-6042
(907) 644-2808
Mailing address
4021 IONA CIR, ANCHORAGE, AK 99507-3341
(907) 344-6042
(907) 644-2808

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
39
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
39
PROFESSIONAL SLP LICENSE
AK
05
SP9180
AK
Enumeration date
01/08/2007
Last updated
07/09/2007
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