Individual
DR. MOLLY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
2101 ROBIN AVE STE 5, HAMMOND, LA 70403-5773
(985) 230-5390
(985) 230-5391
Mailing address
15790 PAUL VEGA MD DR, HAMMOND, LA 70403-1436
(985) 345-2700
(985) 230-6652
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1794
LA
103TC1900X
Counseling Psychologist
46810
MS
103TC1900X
Counseling Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01289231
—
MS
01
—
1794
LICENSE
LA
01
—
302I681423
MEDICARE PTAN
MS
Enumeration date
06/15/2007
Last updated
08/04/2026
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