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Individual
MICHAEL CLARK
Active
Individual
MICHAEL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, BCBA
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
06/06/2022
Last updated
08/22/2024
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