Individual
MRS. JANELLE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
4000 GENESEE PL, SUITE 205, WOODBRIDGE, VA 22192-8302
(571) 402-7499
(571) 402-7237
Mailing address
904 PRINCESS ANNE ST, SUITE 407, FREDERICKSBURG, VA 22401-5801
(540) 479-3889
(540) 479-3946
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
0133000648
VA
Other
Enumeration date
07/22/2016
Last updated
07/22/2016
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