Individual
MARIANNE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
3804 CHURCH RD, MOUNT LAUREL, NJ 08054-1106
(862) 219-1125
Mailing address
3804 CHURCH RD, MOUNT LAUREL, NJ 08054-1106
(862) 219-1125
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
SI00357800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7819307
—
NJ
Enumeration date
01/24/2006
Last updated
10/24/2019
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