Individual
ELLEN C CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RBT
Contact information
Practice address
7725 W 87TH ST, OVERLAND PARK, KS 66212-1905
(913) 649-3838
Mailing address
2400 W 45TH AVE, KANSAS CITY, KS 66103-3404
(918) 813-9623
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-17-37106
KS
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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