Individual
DR. WILLIAM H CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
530 N MAPLE AVE, RIDGEWOOD, NJ 07450-1610
(201) 689-8293
(201) 689-8293
Mailing address
311 KENILWORTH RD, RIDGEWOOD, NJ 07450-5201
(201) 689-8293
(201) 689-8293
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35SI00115900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0184705
—
NJ
Enumeration date
07/25/2006
Last updated
07/08/2007
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