Individual
DR. MARY MCGINN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
10981 SAN DIEGO MISSION RD, STE 114, SAN DIEGO, CA 92108-2448
(619) 280-0285
(619) 280-0286
Mailing address
10981 SAN DIEGO MISSION RD, STE 114, SAN DIEGO, CA 92108-2448
(619) 280-0285
(619) 280-0286
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PSY 17897
CA
106H00000X
Marriage & Family Therapist
MFC 17748
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EPS004410
—
CA
Enumeration date
05/23/2005
Last updated
11/01/2011
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