Shannon Clark in Manhattan - Developmental Therapist
Shannon Clark - NPI 1417079104
Shannon Clark is a Developmental Therapist in Manhattan, Illinois. Shannon Clark practices all healthcare services and medical treatments related to Developmental Therapist. The NPI Number for Shannon Clark is 1417079104. The last update date is 2007-07-08.
Shannon Clark's current location address is 25225 Shannon Dr, Manhattan, Illinois. You can contact this provider via phone number 7084487423 and fax number 7084487843. The mailing address for Shannon Clark is 25225 Shannon Dr, Manhattan, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shannon Clark |
|---|---|
| Address | 25225 Shannon Dr, Manhattan, Illinois |
| Phone Number | 7084487423 |
| Fax Number | 7084487843 |
| Sole Proprietor | N |
| Credentials | B.S |
NPI Number Detail
| NPI Number | 1417079104 |
|---|---|
| Provider Enumeration Date | 2007-04-04 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 25225 Shannon Dr |
|---|---|
| City | Manhattan |
| State | Illinois (IL) |
| Post Code | 604426203 |
| Phone Number | 7084487423 |
| Fax Number | 7084487843 |
Provider's Primary Taxonomy Detail
| Speciality | Developmental Therapist |
|---|---|
| Taxonomy | 222Q00000X |
|
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 provider identifier assigned to Shannon Clark?
The Shannon Clark has been issued the NPI (National Provider Identifier) 1417079104 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete street address where Shannon Clark is physically located?
The Shannon Clark is physically situated at the following address: 25225 Shannon Dr, Manhattan, IL, 604426203.
What is Shannon Clark's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Shannon Clark is Developmental Therapist, and the corresponding taxonomy classification code for this specialized field is 222Q00000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1417079104 to Shannon Clark?
The Centers for Medicare & Medicaid Services assigned the 1417079104 to Shannon Clark on 2007-04-04.
When was the information regarding Shannon Clark, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Shannon Clark, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-07-08.
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