Clark, Lisa L

Clark, Lisa L is an individual health care provider with primary practice located at 8134 Country Village Dr #102, Cordova TN 38016. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Clark, Lisa L can be contacted via phone (901) 756-8398.

Contact Information

Primary practice address
8134 Country Village Dr #102 Cordova TN 38016
Phone: (901) 756-8398
Fax: (901) 756-8701
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X HSP-1188 Tennessee

Profile Details

NPI number 1396754370
LBN Legal business name Clark, Lisa L
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 7th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1396754370 NPPES
Tennessee MEDICAID 3682232

Popular Providers