Home » Vermont » 05676 » Alice Ann Clark

Alice Ann Clark (PHD)

Alice Ann Clark (PHD) is a health care provider specializes in Psychologist. She.

profile-icon Basic Information

Practice Location 55 S Main St, Waterbury, VT 05676-1556, US
Practice Location Phone802-585-0297
Practice Location Fax
GenderFemale
Specialty InPsychologist
Medical SchoolOther
Graduation Year1995
NPI ?1598813073
PECOS ID4981688405
Enrollment IDI20040614001137
Entity TypeIndividual
Enumeration Date ? Jan 8, 2007
Last Update Date ? Dec 1, 2010
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).
PECOS: Provider Enrollment, Chain, and Ownership System.

specialty-icon Specialties & Licenses of Alice Ann Clark

SpecialtySpecializationLicenseLicense State
PsychologistClinical 048.0057921Vermont
PsychologistClinical 7094Massachusetts

Medicare-icon Medicare Participation of Alice Ann Clark

Accepts Medicare AssignmentYes
Report Quality Measures
Use Electronic Health Records
Committed to Teart Health Through the Million HeartsĀ® initiative

legacy-id-icon Legacy Provider IDs of Alice Ann Clark

Provider IdIssuer StateIssuer TypeIssuer
CLW51246Medicare Id-type Unspecified
W06Z86MassachusettsOtherBCBS