Individual
PAUL JEFFREY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1010 SOUTH 7650 EAST, CROW NORTHERN CHEYENNE INDIAN HOSPITAL, CROW AGENCY, MT 59022
(406) 638-3500
(406) 638-3569
Mailing address
PO BOX 9, CROW N CHEYENNE HOSPITAL BEHAVIORAL HEALTH, CROW AGENCY, MT 59022-0009
(406) 638-3491
(406) 638-3431
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1414
WI
Other
Enumeration date
07/13/2006
Last updated
07/08/2007
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