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1912596040
LARISSE A CLARK
SPRING LAKE, NC
NPI
1912596040
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-01-13
Last Update Date
2021-01-13
Business Address
LARISSE A CLARK
1018 N BRAGG BLVD
SPRING LAKE, NC 28390-3316
Phone number: 910-295-2609
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Mailing Address
LARISSE A CLARK
3522 GRENEDINE DR
FAYETTEVILLE, NC 28306-5610
Phone number: 704-345-3845
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