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NPI Code Detail

MEDICARE: TATIANA CLARKE M.S., CCC-SLP

MEDICARE: TATIANA CLARKE M.S., CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSP-886NV

General Provider Information

NPI Number : 1346458858
Entity Type Code : Individual
Provider Name (Legal Business Name) : TATIANA CLARKE M.S., CCC-SLP
Provider Business Mailing Address
First Line : 1161 S VALLEY VIEW BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1854
Country : US
Telephone Number : 702-486-7670
Fax Number : 702-486-7686
Provider Business Practice Location Address
First Line : 1161 S VALLEY VIEW BLVD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89102-1854
Country : US
Telephone Number : 702-486-7670
Fax Number : 702-486-7686
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2007
Last Update Date : 04/28/2010

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Directions to “ TATIANA CLARKE M.S., CCC-SLP” Practice Location

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