Individual provider · Type 1 NPI

Shannon Clark, B.S

Developmental Therapist · Palos Heights, IL

NPI number 1417079104 Active

Practice location

7440 W College Dr, Suite 200
Palos Heights, IL 60463-1375

Call (708) 448-7423 Map

Fax (708) 448-7843

Mailing address

25225 Shannon Dr
Manhattan, IL 60442-6203

Specialties and licenses

TaxonomyCodeLicense
Developmental Therapist Primary 222Q00000XNone listed

Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…

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About NPI 1417079104

Shannon Clark, B.S's National Provider Identifier is 1417079104, issued on Apr 4, 2007. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Palos Heights, IL. The record was last updated on Jul 8, 2007.