Individual
MARY ELIZABETH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2707 W EDGEWOOD DR STE 104, JEFFERSON CITY, MO 65109-5886
(573) 260-1665
Mailing address
2707 W EDGEWOOD DR STE 104, JEFFERSON CITY, MO 65109-5886
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
2025030237
MO
Other
Enumeration date
10/13/2025
Last updated
10/13/2025
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