NPI 1457606832

Jessica Ann Clark, AUD

Practitioner Audiologist Eagle, ID

Practice location

Address: 3101 E State St Suite 2108, Eagle, ID 83616-6232
Phone: (208) 489-4975
Fax: (208) 489-4089

Registered specialties

Audiologist Primary

Speech, Language and Hearing Service Providers Taxonomy 231H00000X Licence AUD-2269 (ID)

Other Audiologist providers in Idaho →

Registry record

NPI: 1457606832
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 Jul 2012
Record last updated: 27 Feb 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.