Individual
DR. MARK A CLEMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
506 RICHARDSON ST., ATHENS, TX 75751-3430
(903) 677-4800
(903) 677-4803
Mailing address
506 RICHARDSON ST., ATHENS, TX 75751-3430
(903) 677-4800
(903) 677-4803
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
32132
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165882501
—
TX
Enumeration date
10/02/2006
Last updated
07/01/2008
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