Individual
TANISHA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1920 BRIARCLIFF RD NE, ATLANTA, GA 30329-4010
(404) 785-9400
(404) 785-9068
Mailing address
1920 BRIARCLIFF RD NE, ATLANTA, GA 30329-4010
(404) 785-9400
(404) 785-9068
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
10/24/2024
Last updated
10/24/2024
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