Provider Demographics
NPI:1073144390
Name:CLARK SPEECH THERAPY SERVICES
Entity Type:Organization
Organization Name:CLARK SPEECH THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-389-5933
Mailing Address - Street 1:2102 ABERNATHY DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6714
Mailing Address - Country:US
Mailing Address - Phone:843-389-5933
Mailing Address - Fax:843-962-5352
Practice Address - Street 1:2102 ABERNATHY DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6714
Practice Address - Country:US
Practice Address - Phone:843-389-5933
Practice Address - Fax:843-962-5352
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech