Individual
DR. MARIEL LAKEITHA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
191 KATHERINE AVE, OZARK, AL 36360-1976
(334) 774-7704
(334) 774-7704
Mailing address
191 KATHERINE AVE, OZARK, AL 36360-1976
(334) 774-7704
(334) 774-7704
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1838
AL
Other
Enumeration date
09/16/2013
Last updated
09/16/2013
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