Individual
JOSHUA WAYNE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4037 STE A 214, PHELAN, CA 92371
(760) 964-0153
Mailing address
4037 STE A 214, PHELAN, CA 92371
(760) 964-0153
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
08/31/2023
Last updated
08/31/2023
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