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Individual

AL CLARKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
55 CARLTON ST, ATHENS, GA 30602-1526
(706) 542-8621
(706) 583-0217
Mailing address
55 CARLTON ST, ATHENS, GA 30602-1526
(706) 542-8621
(706) 583-0217

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY002148
GA

Other

Enumeration date
02/05/2008
Last updated
10/22/2009
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