Individual
ADAM CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2625 TOWNSGATE RD, WESTLAKE VILLAGE, CA 91361-5751
(805) 413-3009
Mailing address
2947 KILAINE DR, SIMI VALLEY, CA 93063-2129
(818) 419-7329
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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