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General NPI Number Information
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NPI Number | 1780963793
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Entity Type | Individual
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Provider Name | JOY HUMPHREYS CLARK PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/08/2011
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 1002 ARBOR PARK DR STE 101
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City | BELTON
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State | TX
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Zip | 76513-8585
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Country | US
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Telephone | 254-262-6743
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Fax | 855-514-2815
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Provider Business Mailing Address
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Address Line | 1002 ARBOR PARK DR STE 101
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City | BELTON
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State | TX
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Zip | 76513-8585
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Country | US
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Telephone | 254-262-6743
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Fax | 855-514-2815
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 38458
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License Number State | TX
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