Individual
DR. JEFFREY P. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
339 W LOUCKS ST, SHERIDAN, WY 82801-4121
(307) 674-4462
(307) 674-4552
Mailing address
1969 S SHERIDAN AVE, SHERIDAN, WY 82801-6108
(307) 672-7481
(307) 674-5117
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
409
WY
Other
Enumeration date
11/02/2005
Last updated
07/08/2007
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