Jill M Clark, CCC-SLP is a
Speech-language Pathologist based in Hiram, Georgia. Jill M Clark is licensed to practice in Georgia (license number SLP006990) and her current practice location is
147 Trailside Cir, Hiram, Georgia. She can be reached at her office (for appointments etc.) via phone at
(229) 873-1535.
NPI number for Jill M Clark is 1922368075 and her current mailing address is 147 Trailside Cir, Hiram, Georgia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1922368075.
Healthcare Provider's Profile
| Full Name | Jill M Clark |
|---|
| Gender | Female |
|---|
| Speciality | Speech-language Pathologist |
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| Location | 147 Trailside Cir, Hiram, Georgia |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1922368075
- Provider Enumeration Date: 05/23/2012
- Last Update Date: 10/25/2019
Medical Identifiers
Medical identifiers for Jill M Clark such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1922368075 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 235Z00000X | Speech-language Pathologist | SLP006990 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jill M Clark is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jill M Clark, CCC-SLP
147 Trailside Cir,
Hiram, GA 30141-3277
Ph: (229) 873-1535 | Jill M Clark, CCC-SLP
147 Trailside Cir,
Hiram, GA 30141-3277
Ph: (229) 873-1535 |
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