Individual
RACHEAL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., BCBA
Contact information
Practice address
6100 DAYLONG LN STE 103, CLARKSVILLE, MD 21029-1631
(410) 531-8100
Mailing address
6100 DAYLONG LN STE 103, CLARKSVILLE, MD 21029-1631
(410) 531-8100
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
06447
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/28/2019
Last updated
10/19/2021
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