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NPI Code Detail

MEDICARE: DEBBIE CLARKE SLP

MEDICARE: DEBBIE CLARKE 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 PathologistSA442FL
2222Q00000XDevelopmental TherapistSA442FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1730263773
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBBIE CLARKE SLP
Provider Business Mailing Address
First Line : 287 EDINBURGH LN
Second Line :
City : ORANGE PARK
State : FL
Zip : 32073-4231
Country : US
Telephone Number : 904-272-6792
Fax Number :
Provider Business Practice Location Address
First Line : 910 N JEFFERSON ST
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32209-6810
Country : US
Telephone Number : 904-360-7022
Fax Number : 904-798-4544
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 03/25/2011

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Directions to “ DEBBIE CLARKE SLP” Practice Location

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