Individual
THOMAS LYON CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1515 PAYNE ST, TALLAHASSEE, FL 32303-5796
(850) 345-9119
Mailing address
1515 PAYNE ST, TALLAHASSEE, FL 32303-5796
(850) 224-1515
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY3647
FL
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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