Individual
DR. SHANNON CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
7750 CLAYTON RD STE 312, SAINT LOUIS, MO 63117-1341
(314) 866-3957
Mailing address
4625 LINDELL BLVD, SAINT LOUIS, MO 63108-3725
(314) 866-3957
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
12016019-2501
UT
103T00000X
Psychologist
Primary
2021045663
MO
Other
Enumeration date
04/26/2021
Last updated
08/29/2024
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