Individual
DR. LISA L CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
8134 COUNTRY VILLAGE DR, #102, CORDOVA, TN 38016
(901) 756-8398
(901) 756-8701
Mailing address
PO BOX 341065, MEMPHIS, TN 38184-1065
(901) 385-2342
(901) 382-0140
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
HSP-1188
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3682232
—
TN
Enumeration date
08/07/2006
Last updated
07/08/2007
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