Individual
ASHLEY DENISE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPP, BCBA-LBA
Contact information
Practice address
5000 KY ROUTE 321, PRESTONSBURG, KY 41653-9113
(606) 889-3610
(606) 886-1316
Mailing address
PO BOX 280, PRESTONSBURG, KY 41653-0280
(606) 349-7475
(606) 349-7476
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0070
KY
103T00000X
Psychologist
PSYPPR00216455
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30610026
—
KY
Enumeration date
06/24/2008
Last updated
01/29/2021
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