Clark, Marianne
Clark, Marianne is an individual health care provider with primary practice located at 3804 Church Rd , Mount Laurel NJ 08054-1106. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Clark, Marianne can be contacted via phone (862) 219-1125.Contact Information
Primary practice address
3804 Church Rd
Mount Laurel NJ 08054-1106
Phone: (862) 219-1125
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | SI00357800 | New Jersey |
Profile Details
| NPI number | 1235109299 |
|---|---|
| LBN Legal business name | Clark, Marianne |
| Credentials | PSY.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 24th, 2006 |
| Last updated | Oct 24th, 2019 - about 7 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235109299 | NPPES |
| New Jersey | MEDICAID | 7819307 |
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