Individual
KRISTA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
405 N WASHINGTON ST STE 310, FALLS CHURCH, VA 22046-3460
(703) 672-3819
Mailing address
405 N WASHINGTON ST STE 310, FALLS CHURCH, VA 22046-3460
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
0717001837
VA
106H00000X
Marriage & Family Therapist
Primary
AMFT000469
GA
106H00000X
Marriage & Family Therapist
MFT001706
GA
Other
Enumeration date
05/12/2017
Last updated
09/12/2022
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