Mrs. Mandi Lynne Clark
School Psychologist
310 S Coal St
Colchester
, Illinois 62326-1209
Mrs. Mandi Lynne Clark
School Psychologist
310 S Coal St
Colchester
, Illinois 62326-1209
(309) 776-3002
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About
Features
Specialties
- School Psychologist
Languages spoken
- English
Location
First Address
- Mrs. Mandi Lynne Clark
- 737 Madelyn Ave
- Macomb, IL
- Zip : 61455-3030
- Phone : (309) 776-3002
Second Address
- Mrs. Mandi Lynne Clark
- 310 S Coal St
- Colchester, IL
- Zip : 62326-1209
- Fax : (309) 776-3002
- Phone : (309) 776-3002
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 103TS0200X | School Psychologist | 1909260 | IL |
National Provider Identifier
| NPI | 1093239758 |
|---|---|
| Provider Name | Mrs. Mandi Lynne Clark |
| First Address | Macomb, IL 61455-3030 |
| Second Address | Colchester, IL 62326-1209 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/08/2017 |
| Last Update Date | 17/03/2018 |
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.