Individual
DR. R. RAY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
5725 FORWARD AVE, SUITE 300, PITTSBURGH, PA 15217-2255
(412) 621-0551
(412) 621-6414
Mailing address
PO BOX 8128, PITTSBURGH, PA 15217-0128
(412) 621-0551
(412) 621-6414
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS-008392-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016409990005
—
PA
01
—
00180561
BCBS
PA
01
—
S46121
HIGHMARK
—
Enumeration date
10/26/2006
Last updated
08/05/2014
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