Individual
MRS. MANDI LYNNE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCSP
Contact information
Practice address
310 S COAL ST, COLCHESTER, IL 62326-1209
(309) 776-3002
(309) 776-3002
Mailing address
737 MADELYN AVE, MACOMB, IL 61455-3030
(309) 776-3002
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
1909260
IL
Other
Enumeration date
08/02/2017
Last updated
03/17/2018
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