Clark, Melissa Ann

Clark, Melissa Ann is an sole proprietor health care provider with primary practice located at 9431 Haven Ave Ste 100 , Rancho Cucamonga CA 91730-5879. 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, Melissa Ann can be contacted via phone (818) 894-2273.

Contact Information

Primary practice address
9431 Haven Ave Ste 100 Rancho Cucamonga CA 91730-5879
Phone: (818) 894-2273
Fax: (818) 357-2505
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 1980 Arkansas

Profile Details

NPI number 1760546428
LBN Legal business name Clark, Melissa Ann
Credentials MCD, CCC-SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 20th, 2006
Last updated Oct 31st, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760546428 NPPES
Arkansas Other 5X321 BLUE CROSS BLUE SHIELD
Arkansas MEDICAID 149195721 BLUE CROSS BLUE SHIELD

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