| Doctor Name: | BLAIKE ARNOLD CLARK |
| NPI Number: | 1093965634 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYD |
| License Number: | 2013-107 |
| Business Practice Address: | 611 Forest Ave Maysville, KY - 410561411 |
| Business Phone Number: | 6065644016 |
| Business Fax Number: | 6065648288 |
| Mailing Address: | 611 Forest Ave, MAYSVILLE |
| State: | KY |
| Postal Code: | 410561411 |
| Phone Number: | 6065644016 |
| Fax Number: | 6065648288 |
| NPI Enumeration Date: | 09/19/2008 |
| NPI Last Update Date: | 11/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 2013-107 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |