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General NPI Number Information
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NPI Number | 1447624598
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Entity Type | Organization
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Legal Business Name | CLARKE COMMUNICATION SERVICES
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Dates
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Enumeration Date | 11/30/2015
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Last Update Date | 11/30/2015
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Provider Practice Location Address
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Address Line | 1814 FALLSTAFF CT
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City | ELDERSBURG
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State | MD
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Zip | 21784-6274
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Country | US
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Telephone | 443-452-7524
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Fax |
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Provider Business Mailing Address
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Address Line | 1814 FALLSTAFF CT
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City | ELDERSBURG
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State | MD
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Zip | 21784-6274
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Country | US
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Telephone | 443-452-7524
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Fax |
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Authorized Official
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Title or Position | OWNER/SPEECH LANGUAGE PATHOLOGIST
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Name | NICOLE CLARKE
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Credential | MS, CCC-SLP
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Telephone | 443-452-7524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | 05627
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License Number State | MD
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