Individual
CLAYTON V CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1219 K ST NW, ARDMORE, OK 73401-1801
(580) 798-4532
Mailing address
1219 K ST NW, ARDMORE, OK 73401-1801
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/31/2022
Last updated
04/07/2022
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