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Individual

JENNIFER K CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
43130 AMBERWOOD PLZ, SUITE 140, SOUTH RIDING, VA 20152-4105
(703) 542-7770
Mailing address
43130 AMBERWOOD PLZ, SUITE 140, SOUTH RIDING, VA 20152-4105
(703) 542-7770

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810004270
VA

Other

Enumeration date
09/20/2011
Last updated
12/12/2011
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