Clark, Jackie Leah
Clark, Jackie Leah is an sole proprietor health care provider with primary practice located at 601 S Tool Dr , Tool TX 75143-1959. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Clark, Jackie Leah can be contacted via phone (903) 432-1932.Contact Information
Primary practice address
601 S Tool Dr
Tool TX 75143-1959
Phone: (903) 432-1932
Fax: (903) 432-0520
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Audiologist | 231H00000X |
Profile Details
| NPI number | 1417951484 |
|---|---|
| LBN Legal business name | Clark, Jackie Leah |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 8th, 2005 |
| Last updated | Oct 28th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417951484 | NPPES |
| Texas | Other | 66993 | CSHCN |
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