Individual
DR. JOHNETTE ELISSE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1301 N 2ND ST, ATCHISON, KS 66002-1202
(913) 367-1593
(913) 367-1627
Mailing address
130 SU TERRA DR, ATCHISON, KS 66002-1023
(913) 367-2824
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
LP 1021
KS
Other
Enumeration date
11/30/2006
Last updated
07/08/2007
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