Individual
DIANA L. CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4627 RIDGE RD, WADSWORTH, OH 44281-9758
(330) 239-1646
Mailing address
4627 RIDGE RD, WADSWORTH, OH 44281-9758
(330) 239-1724
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4304
OH
Other
Enumeration date
07/05/2006
Last updated
07/08/2007
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