Individual
MARY KATHERINE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,LPE-I
Contact information
Practice address
320 N MAIN ST, GREENWOOD, AR 72936-7031
(479) 996-1414
Mailing address
P. O. BOX 3023, GREENWOOD, AR 72936-3020
(479) 996-1414
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
83-07E-I
AR
103TF0000X
Family Psychologist
83-07E-I
AR
103TP2701X
Group Psychotherapy Psychologist
83-07E-I
AR
103TS0200X
School Psychologist
Primary
83-07E-I
AR
Other
Enumeration date
07/21/2008
Last updated
07/21/2008
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