Individual
CARRIE CECILIA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
5014 W MILLBROOK DR, COLUMBIA, MO 65203-5329
(573) 489-7659
Mailing address
5014 W MILLBROOK DR, COLUMBIA, MO 65203-5329
(573) 489-7659
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2009002722
MO
Other
Enumeration date
11/19/2009
Last updated
12/12/2012
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