Jeffrey P. Clark PSY.D.

NPI 1063403822 - Psychologist - 103TC0700X

NPI Details
NPI 1063403822
Gender Male
Enumeration Date 11/02/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
339 W LOUCKS ST
SHERIDAN WY, 82801-4121, US
Phone (307) 674-4462
Fax (307) 674-4552
Business Location
1969 S SHERIDAN AVE
SHERIDAN WY, 82801-6108, US
Phone (307) 672-7481
Fax (307) 674-5117
Toxanomy
Taxonomy Code 103TC0700X
License State Wyoming
License Number 409
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According to our database, Dr. Jeffrey P. Clark PSY.D. NPI is 1063403822, taxonomy code is 103TC0700X and license number is 409, license state is located at Wyoming. Jeffrey P. Clark PSY.D. physically located at 339 W Loucks St, Sheridan WY, 82801-4121. NPI Number Jeffrey P. Clark PSY.D. has the Individual type.

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1063403822 NPI number is provided on an as is basis without warranty of any kind. 1063403822 is maintained by the National Plan & Provider Enumeration System. The contents of Jeffrey P. Clark PSY.D. are for informational purposes only.