Individual
DR. LORI ELLEN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1095 S MAIN ST, CHESHIRE, CT 06410-3432
(203) 271-3809
(203) 272-6968
Mailing address
9 JACOBS LN, NEWTOWN, CT 06470-2654
(919) 624-3338
(203) 272-6968
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
3952
NC
103TC0700X
Clinical Psychologist
Primary
3952
NC
Other
Enumeration date
06/30/2010
Last updated
02/16/2017
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