NPI | 1548711229 |
---|---|
Former Name | JACLYN CLARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst |
Additional Taxonomies | 101Y00000X Counselor (Licence: VA 0133000853) |
Enumeration Date | 2016-10-18 |
Last Update Date | 2021-06-18 |