Clark, Peggy D

Clark, Peggy D is an individual health care provider with primary practice located at 6 Telcom Dr , Bangor ME 04401-3072. 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, Peggy D can be contacted via phone (207) 941-2850.

Contact Information

Primary practice address
6 Telcom Dr Bangor ME 04401-3072
Phone: (207) 941-2850
Fax: (207) 941-2852
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SP958 Maine

Profile Details

NPI number 1821094897
LBN Legal business name Clark, Peggy D
Credentials SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2005
Last updated Jun 15th, 2021 - about 5 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 1821094897 NPPES
Georgia MEDICAID 704575468A
Georgia Other 10037581
Georgia Other 344119

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