Individual
NICHOLAS CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8835 NORTHPARK CT, JOHNSTON, IA 50131-3018
(515) 207-5251
Mailing address
11428 FOREST AVE APT 1321, CLIVE, IA 50325-7062
(319) 231-5148
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA-01124
IA
Other
Enumeration date
11/22/2024
Last updated
11/22/2024
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