Individual
MALYNDA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6236 AIRPARK DR STE A, CHATTANOOGA, TN 37421-2988
(423) 954-8867
Mailing address
6236 AIRPARK DR STE A, CHATTANOOGA, TN 37421-2988
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790731081
—
KY
Enumeration date
09/30/2014
Last updated
03/15/2022
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