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Individual

CHARLES BRENDAN CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1713 6TH AVE S, BIRMINGHAM, AL 35294-0018
(205) 801-8000
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1731
AL

Other

Enumeration date
07/26/2013
Last updated
07/26/2013
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