Individual
DENISE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 W SPRING ST, MARQUETTE, MI 49855-4630
(906) 233-1236
(906) 233-1235
Mailing address
200 W SPRING ST, MARQUETTE, MI 49855-4630
(906) 233-1236
(906) 233-1235
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-09-3653
BEHAVIOR ANALYST CERTIFICATE
MI
Enumeration date
03/22/2010
Last updated
03/22/2010
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