Individual
PEGGY ANN LOVE-CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
11603 WOOD HBR, SAN ANTONIO, TX 78249-1931
(979) 777-3189
(832) 448-2801
Mailing address
11603 WOOD HBR, SAN ANTONIO, TX 78249-1931
(979) 777-3189
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
23085
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021PB
BCBS
TX
01
—
P00280873
RAILROAD
TX
Enumeration date
07/06/2006
Last updated
10/22/2007
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