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Individual

DR. ELIZABETH CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
825 W END AVE, 1D, NEW YORK, NY 10025-5349
(847) 772-1655
Mailing address
3217 HULL AVE, 7A, BRONX, NY 10467-4317
(847) 772-1655

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
021454
NY

Other

Enumeration date
03/08/2016
Last updated
03/08/2016
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