Individual provider · Type 1 NPI

Davette M. Clark

Developmental Therapist · Country Club Hills, IL

NPI number 1750417614 Active

Practice location

4856 Castle Dargan Dr.
Country Club Hills, IL 60478-5820

Call (708) 957-8616 Map

Fax (708) 957-8617

Mailing address

4856 Castle Dargan Drive
Country Club Hills, IL 60478-5820

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 1750417614

Davette M. Clark's National Provider Identifier is 1750417614, issued on Feb 26, 2007. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Country Club Hills, IL. The record was last updated on Jul 8, 2007.