Individual
SALLY MARIE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
2820 COLUMBIANA RD, STE 210, BIRMINGHAM, AL 35216-2589
(205) 979-6800
(205) 823-5374
Mailing address
2820 COLUMBIANA RD, STE 210, BIRMINGHAM, AL 35216-2589
(205) 979-6800
(205) 823-5374
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2824
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158619
—
AL
01
—
511-39634
BLUE CROSS BLUE SHIELD
AL
Enumeration date
03/20/2009
Last updated
12/02/2016
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