Individual
LISA S CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
1535 N MOUNT JULIET RD, MOUNT JULIET, TN 37122-3315
(615) 973-8242
Mailing address
409 ANTHONY BRANCH DR, MOUNT JULIET, TN 37122-4028
(615) 973-8242
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/13/2026
Last updated
07/13/2026
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