Clark, Andrea
Clark, Andrea is an individual health care provider with primary practice located at 765 Yellowjacket Ln , Clinton AR 72031-6836. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Clark, Andrea can be contacted via phone (501) 745-6000.Contact Information
Primary practice address
765 Yellowjacket Ln
Clinton AR 72031-6836
Phone: (501) 745-6000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 2480 | Arkansas |
Profile Details
| NPI number | 1497941330 |
|---|---|
| LBN Legal business name | Clark, Andrea |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 24th, 2007 |
| Last updated | Aug 21st, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497941330 | NPPES |
| Arkansas | MEDICAID | 164773721 |
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