Provider Demographics
NPI:1467681346
Name:CLARK, FRANCES BYRNES (SLP)
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:BYRNES
Last Name:CLARK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:FRANCES
Other - Middle Name:BYRNES
Other - Last Name:DALTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:81 CAISSON TRCE
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORT
Mailing Address - State:AL
Mailing Address - Zip Code:36527-3107
Mailing Address - Country:US
Mailing Address - Phone:804-467-7655
Mailing Address - Fax:
Practice Address - Street 1:81 CAISSON TRCE
Practice Address - Street 2:
Practice Address - City:SPANISH FORT
Practice Address - State:AL
Practice Address - Zip Code:36527-3107
Practice Address - Country:US
Practice Address - Phone:804-467-7655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3393235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004909976Medicaid