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Individual

MASON SAMUEL CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
751 RHODEN COVE RD, TALLAHASSEE, FL 32312-1013
(850) 815-8800
Mailing address
8581 PINE AVE, MACCLENNY, FL 32063-5011
(904) 646-8518

Taxonomy

Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
BACB1128648
FL

Other

Enumeration date
06/19/2024
Last updated
06/19/2024
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