Organization
WESTERN RESERVE PSYCHOLOGICAL ASSOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA FOWKES CLARK PH D (PRESIDENT)
(330) 650-6338
Entity
Organization
Contact information
Practice address
4833 DARROW ROAD, SUITE 101, STOW, OH 44224-1411
(330) 650-5338
(330) 342-3837
Mailing address
4833 DARROW ROAD, SUITE 101, STOW, OH 44224-1411
(330) 650-5338
(330) 342-3837
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
04/27/2006
Last updated
10/21/2015
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