Individual
ANGELICA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
649 GUILFORD AVE, HAGERSTOWN, MD 21740-6349
(240) 651-9432
Mailing address
300 KIMBERLY WOODS CT, FORT WASHINGTON, MD 20744-5915
(301) 509-5252
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/21/2018
Last updated
10/21/2018
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