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Cory Michael Clark
Speech-Language Assistant in El Mirage, Arizona
NPI 1669021234

Cory Michael Clark is a Speech-Language Assistant based in Tempe, AZ and is specialized in Speech-Language Assistant. Cory Michael Clark practices in El Mirage, AZ. The NPI Number for Cory Michael Clark is 1669021234 and holds a License No. SLPA11879 (Arizona).

The current practice location address for Cory Michael Clark is 12701 N Main St, El Mirage, AZ and can be reached out via phone at 623-217-8544.

Location: 12701 N Main St, El Mirage, AZ, 85282-6905
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1669021234
Provider Name
Cory Michael Clark
Credential
Provider Entity Type
Individual
Gender
Male
Address
12701 N Main St, El Mirage, AZ, 85282-6905
Phone Number
623-217-8544
Fax Number
Provider Enumeration Date
09/06/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
12701 N Main St
City
El Mirage
State
Arizona
Zip
85335-2600
Phone Number
623-217-8544
Fax Number
person
Provider Business Mailing Address Details
Address
12701 N Main St
City
El Mirage
State
Arizona
Zip
85335-2600
Phone Number
623-217-8544
Fax Number
person
Provider's Taxonomy Details 1
Type
Speech, Language and Hearing Service Providers
Classification
Specialist/Technologist
Speciality
Speech-Language Assistant
Taxonomy
2355S0801X
License No.
SLPA11879 (Arizona)
Definition
Definition to come...
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