Individual
MR. CLARK ROBERT THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
86 W SUNBRIDGE DR, FAYETTEVILLE, AR 72703-1822
(479) 435-6360
Mailing address
405 CENTRAL AVE, NORTHFIELD, IL 60093-3006
(847) 441-5600
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
1810AP-PL
AR
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/04/2015
Last updated
10/31/2018
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