Most Relevant Information
Provider Data
| NPI Number: | 1003284274 |
| Provider Name: | CLARK ROBERT THOMPSON MA |
| Entity Type: | Individual |
| Taxonomy Code: | 103T00000X |
| Specialty: | Psychologist |
| License Number: | 1810AP-PL |
Most Important Dates
| Enumeration Date: | 09/04/2015 |
| Last Updated: | 10/31/2018 |
Provider Practice Location
86 W SUNBRIDGE DR
FAYETTEVILLE
AR
727031822
Practice Location Phone/Fax
| Phone: | 4794356360 |
| Fax: |
Provider Mailing Location
405 CENTRAL AVE
NORTHFIELD
IL
600933006
Provider Mailing Phone/Fax
| Phone: | 8474415600 |
| Fax: |