Individual
BENJAMIN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
320 DECKER DR, IRVING, TX 75062-3999
(972) 585-7030
Mailing address
7108 S KANNER HWY, STUART, FL 34997-7462
(855) 832-6727
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/25/2024
Last updated
10/25/2024
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