Individual
AMANDA ELIZABETH CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4505 LAS VIRGENES RD STE 107, CALABASAS, CA 91302-1956
(818) 932-9644
(818) 932-8997
Mailing address
4505 LAS VIRGENES RD STE 107, CALABASAS, CA 91302-1956
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-17-28708
CA
Other
Enumeration date
02/14/2018
Last updated
02/14/2018
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