Individual provider · NPI-1

Kaitlyn Maurene Clark, M.S CCC SLP

Speech-Language Pathologist, · Palm Coast, FL

NPI number1740770940
StatusActive
Last updated in NPPESMay 14, 2018

Details

NPI
1740770940
Entity type
Individual (NPI-1)
Name
Kaitlyn Maurene Clark
Credential
M.S CCC SLP
Sex
Female
Sole proprietor
Yes
Enumeration date
May 14, 2018
Last updated
May 14, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
235Z00000X Speech-Language Pathologist,SA11993FLYes

Practice location

3001 Palm Coast Pkwy Se
Palm Coast, FL 32137-8209

Phone 386-446-6060

Mailing address

3001 Palm Coast Pkwy Se
Palm Coast, FL 32137-8209

Phone 386-446-6060

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