Individual
DR. PETER CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
203 W 21ST AVE, COVINGTON, LA 70433-3151
(985) 867-9333
(985) 892-5057
Mailing address
203 W 21ST AVE, COVINGTON, LA 70433-3151
(985) 867-9333
(985) 892-5057
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
571
LA
Other
Enumeration date
12/11/2006
Last updated
07/08/2007
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