Individual
STEPHANIA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
3703 TAYLORSVILLE RD, SUITE 221, LOUISVILLE, KY 40220-1354
(502) 592-1736
(502) 785-4834
Mailing address
3703 TAYLORSVILLE RD, SUITE 221, LOUISVILLE, KY 40220-1354
(502) 592-1736
(502) 785-4834
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
172204
KY
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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