Individual
DEIRDRE LYNN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
720 SE 160TH AVE # 154, VANCOUVER, WA 98684-8911
(866) 523-4268
(510) 900-4310
Mailing address
DEPT LA 22763, PASADENA, CA 91185-0001
(866) 523-4268
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/27/2023
Last updated
04/27/2023
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