person
Shannon Clark
Speech-Language Assistant in Round Rock, Texas
NPI 1114255734

Shannon Clark is a Speech-Language Assistant based in Round Rock, TX and is specialized in Speech-Language Assistant. Shannon Clark practices in Round Rock, TX. The NPI Number for Shannon Clark is 1114255734 and holds a License No. 35304 (Texas).

The current practice location address for Shannon Clark is 1208 Ih 35 N Ste Q, Round Rock, TX and can be reached out via phone at 512-310-7665 and via fax at 512-310-9228.

Location: 1208 Ih 35 N Ste Q, Round Rock, TX, 78681-4204
person
Provider Profile Details
NPI Number
1114255734
Provider Name
Shannon Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
1208 Ih 35 N Ste Q, Round Rock, TX, 78681-4204
Phone Number
512-310-7665
Fax Number
512-310-9228
Provider Enumeration Date
11/19/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0944746-02 05 TX
0031DG 01 BLUE CROSS BLUE SHIELD
74-2745294 01 TAX ID
institution
Provider Business Practice Location Address Details
Address
1208 Ih 35 N Ste Q
City
State
Zip
78681-4204
Phone Number
512-310-7665
Fax Number
512-310-9228
person
Provider Business Mailing Address Details
Address
1208 Ih 35 N Ste Q
City
State
Zip
78681-4204
Phone Number
512-310-7665
Fax Number
512-310-9228
person
Provider's Taxonomy Details 1
Type
Speech, Language and Hearing Service Providers
Classification
Specialist/Technologist
Speciality
Speech-Language Assistant
Taxonomy
License No.
35304 (Texas)
Definition
Definition to come...
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