Kimberly D Clark, MS, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Clovis, NM
NPI 1336421999 · NPPES record last updated Apr 17, 2019
Key facts
- NPI
- 1336421999
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 105425 (TX)
- Practice address
- 1524 Lexington Road
Clovis, NM 88101-6846 - Phone
- (575) 219-9354
- NPI assigned
- Sep 9, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105425 | TX | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Speech-Language Pathologist | 235Z00000X | 105425 | TX | Yes |
Addresses
Primary practice location
1524 Lexington Road
Clovis, NM 88101-6846
Mailing address
1524 Lexington Rd
Clovis, NM 88101-4418
Phone (575) 219-9354
Other providers in Clovis, NM
- Madeline O Churchman
- Cynthia Cicero
- City of Clovis
- Clarity Mental Health and Wellness
- Haley Clark
- Cash A Clifton
- Clovis Brace Shop
- Clovis Cardiology Associates LLC
- Clovis Chiropractic & Healthcare Center PA
- Clovis Dermatology PA
All providers in Clovis, NM · Speech-Language Pathologist in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.