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Individual

ANITA LYNN CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
3839 CONSTELLATION RD STE C, LOMPOC, CA 93436-0434
(805) 268-5219
(805) 733-0216
Mailing address
565 MILES AVE, SANTA MARIA, CA 93455-2706
(805) 268-5219

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary

Other

Enumeration date
02/19/2020
Last updated
11/23/2020
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