Individual
SANDRA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1025 MAINE ST, QUINCY, IL 62301-4096
(217) 222-6550
(217) 277-2253
Mailing address
1025 MAINE ST, QUINCY, IL 62301-4096
(217) 222-6550
(217) 277-2253
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071-009935
IL
Other
Enumeration date
01/02/2019
Last updated
09/10/2019
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