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Organization

CLARK PSYCHOLOGICAL ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DANIEL C CLARK PH.D. (OWNER)
(334) 300-7021
Entity
Organization

Contact information

Practice address
3196 PARLIAMENT CIRCLE, MONTGOMERY, AL 36116-0000
(334) 300-7021
Mailing address
9571 WINFIELD PL, MONTGOMERY, AL 36117-5157
(334) 300-7021

Taxonomy

Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
Primary
1076
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1225093891
NPI - PERSONAL ISSUED TO DR. CLARK
Enumeration date
12/10/2008
Last updated
12/10/2008
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