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MRS. MEGHAN REBECCA CLARK MS CCC-SLP

>> Speech-Language Pathologist >> Speech, Language and Hearing Service Providers

Registrant NPI Number: 1558873273

Individual Registrant:
MRS. MEGHAN REBECCA CLARK MS CCC-SLP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
319 FERRY ST  BROOKPORT, IL 62910-2891 US
Tel: 618-564-2482  Fax: --

Contact information for business:
216 BROOKFIELD DR  PADUCAH, KY 42001-5306 US
Tel: 270-293-6374  Fax: --

Registration Information:
NPI: 1558873273
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y235Z00000XSpeech, Language and Hearing Service Providers
Speech-Language Pathologist
IL1915639

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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