Individual
HANNAH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
515 N HICKORY ST APT 202, CHAMPAIGN, IL 61820-3889
(779) 236-6844
Mailing address
515 N HICKORY ST APT 202, CHAMPAIGN, IL 61820-3889
(779) 236-6844
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071010348
IL
Other
Enumeration date
07/31/2014
Last updated
09/28/2020
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