Individual
DANIEL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
9685 SW JOHNSON ST APT 25, TIGARD, OR 97223-5276
(661) 433-3358
Mailing address
9685 SW JOHNSON ST APT 25, TIGARD, OR 97223-5276
(661) 433-3358
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
B-10212991
OR
Other
Enumeration date
08/27/2013
Last updated
06/20/2022
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