Individual
ANGELINA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2765 RICHMOND HWY STE 105, STAFFORD, VA 22554-8331
(540) 699-2381
(540) 301-2788
Mailing address
2765 RICHMOND HWY STE 105, STAFFORD, VA 22554-8331
(540) 699-2381
(540) 301-2788
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-23-276729
VA
Other
Enumeration date
07/18/2023
Last updated
07/18/2023
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