Individual
TIFFANY NICOLE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFTA
Contact information
Practice address
2300 W FM 544 STE 245, WYLIE, TX 75098-4931
(214) 307-9546
Mailing address
300 TRAILHOUSE LN APT 2125, FORNEY, TX 75126-3184
(469) 744-0800
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
205317
TX
Other
Enumeration date
02/20/2024
Last updated
02/20/2024
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