Provider Demographics
NPI:1003957143
Name:PALMER, CLARENCE O (M S CCCA)
Entity Type:Individual
Prefix:MR
First Name:CLARENCE
Middle Name:O
Last Name:PALMER
Suffix:
Gender:M
Credentials:M S CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 CENTRAL AVE
Mailing Address - Street 2:SUITE 174
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-7440
Mailing Address - Country:US
Mailing Address - Phone:501-525-9996
Mailing Address - Fax:501-525-2155
Practice Address - Street 1:4501 CENTRAL AVE
Practice Address - Street 2:SUITE 174
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-7440
Practice Address - Country:US
Practice Address - Phone:501-525-9996
Practice Address - Fax:501-525-2155
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARABESPA #41-AUD231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist