Individual
JANELLE CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
140 GOULD ST, NEEDHAM, MA 02494-2397
(781) 433-9890
Mailing address
140 GOULD ST, NEEDHAM, MA 02494-2397
(781) 433-9890
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2319
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2319
STATE MA LICENSE
—
Enumeration date
04/02/2019
Last updated
04/02/2019
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