Individual
VIRGINIA FOWKES CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4833 DARROW ROAD SUITE 101, STOW, OH 44224-1411
(330) 650-5338
(330) 342-3837
Mailing address
4833 DARROW ROAD SUITE 101, STOW, OH 44224-1411
(330) 650-5338
(330) 342-3837
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
5928
OH
103T00000X
Psychologist
PS008980L
PA
103TB0200X
Cognitive & Behavioral Psychologist
5928
OH
103TC0700X
Clinical Psychologist
5928
OH
103TC2200X
Clinical Child & Adolescent Psychologist
5928
OH
103TF0000X
Family Psychologist
5928
OH
103TH0100X
Health Service Psychologist
5928
OH
Other
Enumeration date
05/03/2006
Last updated
12/08/2010
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