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Dr. Peter Clark, Ph.D.

Psychologist, Clinical Child & Adolescent in Covington, LA. Individual provider (NPI-1).

NPI number1447310289
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1447310289
Entity type
Individual (NPI-1)
Name
Dr. Peter Clark
Credential
Ph.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
Dec 11, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
103TC2200X Psychologist, Clinical Child & Adolescent571LAYes

Practice location

203 W 21st Ave
Covington, LA 70433-3151

Phone 985-867-9333 · Fax 985-892-5057

Mailing address

203 W 21st Ave
Covington, LA 70433-3151

Phone 985-867-9333 · Fax 985-892-5057

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