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DR. TANA M CLARK PH.D

>> Psychologist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1992908891

Individual Registrant:
DR. TANA M CLARK PH.D
Gender: F
Sole Proprietor

Location and contact information for practice:
100 TAMAL PLZ SUITE 160 CORTE MADERA, CA 94925-1125 US
Tel: 415-924-6935  Fax: --

Contact information for business:
100 TAMAL PLZ SUITE 160 CORTE MADERA, CA 94925-1125 US
Tel: 415-924-6935  Fax: --

Registration Information:
NPI: 1992908891
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103T00000XBehavioral Health & Social Service Providers
Psychologist
CAPSY#14966

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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