Individual
CAROL ANNE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
5201 ROMA AVE NE, ALBUQUERQUE, NM 87108-1334
(505) 610-0037
Mailing address
5201 ROMA AVE NE, ALBUQUERQUE, NM 87108-1334
(505) 610-0037
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3706
NM
Other
Enumeration date
08/01/2007
Last updated
08/01/2007
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