KEVIN CLARK

FAIRFAX, VA
NPI1245851104
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: VA  0710103244)
Enumeration Date2020-05-01
Last Update Date2021-04-26
Business Address
KEVIN CLARK
10615 JUDICIAL DR STE 403
FAIRFAX, VA 22030-7501
Phone number: 703-565-3783
Mailing Address
KEVIN CLARK
7900 SCULLY CT
MANASSAS, VA 20111-8268
Phone number: 703-477-4830
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