Jeffrey Paul Clark
Clinical Psychologist
1932 Viking Dr Nw
Rochester
, Minnesota 55901-2460
Jeffrey Paul Clark
Clinical Psychologist
1932 Viking Dr Nw
Rochester
, Minnesota 55901-2460
(507) 261-2777
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About
Features
Specialties
- Clinical Psychologist
Languages spoken
- English
Location
First Address
- Jeffrey Paul Clark
- 1926 26th Ave Nw
- Rochester, MN
- Zip : 55901-8064
- Phone : (507) 261-2777
Second Address
- Jeffrey Paul Clark
- 1932 Viking Dr Nw
- Rochester, MN
- Zip : 55901-2460
- Phone : (180) 042-2016
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103G00000X | Clinical Psychologist | LP3310 | MN |
| Y | 103TC0700X | Clinical Psychologist | LP3310 | MN |
National Provider Identifier
| NPI | 1003979600 |
|---|---|
| Provider Name | Jeffrey Paul Clark |
| First Address | Rochester, MN 55901-8064 |
| Second Address | Rochester, MN 55901-2460 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/12/2006 |
| Last Update Date | 08/07/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.