Individual
MRS. PAULETTE ELIZABETH CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA, LABA
Contact information
Practice address
90 S MAIN ST, BERKLEY, MA 02779-2000
(508) 386-0544
Mailing address
90 S MAIN ST, BERKLEY, MA 02779-2000
(508) 386-0544
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
000001448
MA
103K00000X
Behavior Analyst
1010601
MA
Other
Enumeration date
08/05/2010
Last updated
10/31/2017
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