Individual
DR. ALICIA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
339 W LOUCKS ST, SHERIDAN, WY 82801-4121
(307) 674-4462
Mailing address
8 S FORK DR, SHERIDAN, WY 82801-8813
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
438
WY
Other
Enumeration date
10/06/2006
Last updated
07/08/2007
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