JOHN E CLARK

FAIRFAX, VA
NPI1699824763
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: VA  0710101131)
Enumeration Date2007-01-09
Last Update Date2007-07-08
Business Address
Mr. JOHN E CLARK
10390 DEMOCRACY LN
FAIRFAX, VA 22030-2522
Phone number: 703-219-2578
Mailing Address
Mr. JOHN E CLARK
11561 SHADBUSH CT
RESTON, VA 20191-3009
Phone number:
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