Individual
CHRISTINE MARY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A . ED.
Contact information
Practice address
4560 CLAYTON AVE, SAINT LOUIS, MO 63110-1502
(314) 977-0175
(314) 977-0023
Mailing address
455 THUNDERHEAD CANYON DR, WILDWOOD, MO 63011-1736
(636) 458-5100
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Enumeration date
05/25/2007
Last updated
07/08/2007
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