Provider Demographics
NPI:1588451157
Name:CLARK, LINDA LEE (BSED)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LEE
Last Name:CLARK
Suffix:
Gender:
Credentials:BSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 37TH ST
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:TX
Mailing Address - Zip Code:79549-5226
Mailing Address - Country:US
Mailing Address - Phone:325-864-3144
Mailing Address - Fax:
Practice Address - Street 1:2901 37TH ST
Practice Address - Street 2:
Practice Address - City:SNYDER
Practice Address - State:TX
Practice Address - Zip Code:79549-5226
Practice Address - Country:US
Practice Address - Phone:325-864-3144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist