Clark, Teralea M

Clark, Teralea M is an individual health care provider with primary practice located at 7701 Lake Worth Rd , Lake Worth FL 33467-2536. She recently has only one registered license in Speech, Language and Hearing Service Providers / Hearing Instrument Specialist, which is considered as her primary health care specialty. Clark, Teralea M can be contacted via phone (561) 439-8821.

Contact Information

Primary practice address
7701 Lake Worth Rd Lake Worth FL 33467-2536
Phone: (561) 439-8821
Fax: (561) 439-5035
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Hearing Instrument Specialist 237700000X AS2652 Florida

Profile Details

NPI number 1760589550
LBN Legal business name Clark, Teralea M
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Oct 15th, 2008 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760589550 NPPES
Florida MEDICAID 610124100

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