Individual
DR. GARY MIKE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.F.T.
Contact information
Practice address
8911 3RD STREET RD, LOUISVILLE, KY 40272-2501
(502) 523-5433
Mailing address
8014 RED BUD HILL DR, LOUISVILLE, KY 40228-2215
(502) 523-5433
(502) 239-1651
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
KY-0272
KY
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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