| NPI | 1659328052 |
|---|---|
| Former Name | NILDA M. CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MA 7654) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MA 7654) |
| 103TC0700X Psychologist, Clinical (Licence: MA 7654) | |
| 103TF0200X Psychologist, Forensic (Licence: MA 7654) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2016-03-11 |