Thomas Edward Clark LMFT, LMFT

NPI 1053558205 - Student in an Organized Health Care Education/Training Program - 390200000X

NPI Details
NPI 1053558205
Gender Male
Enumeration Date 01/09/2009
Last Updated 09/05/2014
Entity Type Individual
Active Over 8 years ago
Practice Location
980 WESTERN AVENUE
ALBANY NY, 12202, US
Phone (518) 662-0621
Fax
Business Location
980 WESTERN AVENUE
ALBANY NY, 12202, US
Phone (518) 662-0621
Fax
Toxanomy
Taxonomy Code 390200000X
License State California
License Number 56783
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According to our database, Mr. Thomas Edward Clark LMFT, LMFT NPI is 1053558205, taxonomy code is 390200000X and license number is 56783, license state is located at California. Thomas Edward Clark LMFT, LMFT physically located at 980 Western Avenue, Albany NY, 12202. NPI Number Thomas Edward Clark LMFT, LMFT has the Individual type.

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1053558205 NPI number is provided on an as is basis without warranty of any kind. 1053558205 is maintained by the National Plan & Provider Enumeration System. The contents of Thomas Edward Clark LMFT, LMFT are for informational purposes only.