Davette M Clark in Country Club Hills - Developmental Therapist
Davette M Clark - NPI 1750417614
Davette M Clark is a Developmental Therapist in Country Club Hills, Illinois. Davette M Clark practices all healthcare services and medical treatments related to Developmental Therapist. The NPI Number for Davette M Clark is 1750417614. The last update date is 2007-07-08.
Davette M Clark's current location address is 4856 Castle Dargan Drive, Country Club Hills, Illinois. You can contact this provider via phone number 7089578616 and fax number 7089578617. The mailing address for Davette M Clark is 4856 Castle Dargan Drive, Country Club Hills, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Davette M Clark |
|---|---|
| Address | 4856 Castle Dargan Drive, Country Club Hills, Illinois |
| Phone Number | 7089578616 |
| Fax Number | 7089578617 |
| Sole Proprietor | Y |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1750417614 |
|---|---|
| Provider Enumeration Date | 2007-02-26 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 4856 Castle Dargan Drive |
|---|---|
| City | Country Club Hills |
| State | Illinois (IL) |
| Post Code | 604785820 |
| Phone Number | 7089578616 |
| Fax Number | 7089578617 |
Provider's Primary Taxonomy Detail
| Speciality | Developmental Therapist |
|---|---|
| Taxonomy | 222Q00000X |
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Definition: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education |
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Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Davette M Clark by the Centers for Medicare & Medicaid Services?
The Davette M Clark has been issued the NPI (National Provider Identifier) 1750417614 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Davette M Clark is physically located?
The Davette M Clark is physically situated at the following address: 4856 Castle Dargan Drive, Country Club Hills, IL, 604785820.
What is Davette M Clark's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Davette M Clark is Developmental Therapist, and the corresponding taxonomy classification code for this specialized field is 222Q00000X.
On what date did the Davette M Clark receive its 1750417614 assignment from the Centers for Medicare & Medicaid Services?
The Davette M Clark was assigned its 1750417614 by the Centers for Medicare & Medicaid Services on 2007-02-26.
As of what date were the details pertaining to Davette M Clark last refreshed?
The information related to the Davette M Clark, including its address, specialty, and other relevant details, was last updated on 2007-07-08.