Individual
MR. DOUGLASS BURNS CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.DIV
Contact information
Practice address
1559 COUNTY ROUTE 5, CANAAN, NY 12029
(917) 968-2493
Mailing address
P.O. BOX 75, CANAAN, NY 12029
(917) 968-2493
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
000546
NY
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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