Individual
ELIZAVETA VALERIEVNA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1409 KEMPSVILLE RD, CHESAPEAKE, VA 23320-8134
(757) 578-8608
Mailing address
1401 HIGHGATE CT, CHESAPEAKE, VA 23322-8096
(757) 504-7739
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-332628
VA
Other
Enumeration date
08/19/2025
Last updated
08/19/2025
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