Individual
PATRICIA ELLEN CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
34-3 SHUNPIKE RD # 196, CROMWELL, CT 06416-2490
(860) 604-6729
Mailing address
34-3 SHUNPIKE RD # 196, CROMWELL, CT 06416-2490
(860) 604-6729
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-28526
CT
Other
Enumeration date
04/11/2018
Last updated
04/11/2018
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