Individual
EBONY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7000 PARADISE RD APT 2046, LAS VEGAS, NV 89119-4480
(760) 587-5685
Mailing address
7000 PARADISE RD APT 2046, LAS VEGAS, NV 89119-4480
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164669479
—
NV
Enumeration date
03/22/2013
Last updated
03/22/2013
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