NPI 1376973834 · live from the CMS NPI Registry
Kristi M Clark, MA
Audiologist in South Charleston, WV. National Provider Identifier 1376973834, active.
NPI record
| NPI | 1376973834 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Audiologist 231H00000X |
| Practice location | 313 Maccorkle Ave Sw, South Charleston, WV 25303 |
| Practice phone | 304-744-2300 |
| Enumerated | November 20, 2013 |
| Last updated | August 7, 2014 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Audiologist primary | 231H00000X | A-0211 (WV) |
| Audiologist | 231H00000X | A.01642 (OH) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.