Individual
MRS. LISA JAN BOHNE CLAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
2711 SHADOW LAKE DR, GREENWOOD, AR 72936
(479) 414-1703
Mailing address
2711 SHADOW LAKE DR, GREENWOOD, AR 72936
(479) 414-1703
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
9811E
AR
Other
Enumeration date
02/01/2008
Last updated
02/04/2008
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