Individual
ANDREA JANA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3920 ZEENAT DR, INDIANAPOLIS, IN 46254-3135
(317) 300-3938
Mailing address
3920 ZEENAT DR, INDIANAPOLIS, IN 46254-3135
(317) 300-3938
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
9371119383
IN
Other
Enumeration date
12/01/2025
Last updated
12/01/2025
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