SearchIllinois152WV0400X

Christine Clark, PH.D., TVI, DTV

NPI 1043495179 · on the registry since 2008 · sole proprietor

Practice

Address
221 Woodland Ave
Bloomington, IL 61701
Phone
(309) 824-5841

Registry record

Primary taxonomy
152WV0400X
152WV0400X
Licence states on file
UT
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2008-01-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois