Individual
NELLDA CLARK IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
29 E MOUNTAIN ST, WORCESTER, MA 01606-1400
(508) 755-0556
Mailing address
29 E MOUNTAIN ST, WORCESTER, MA 01606-1400
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
08/09/2021
Last updated
09/01/2021
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