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Individual

ERIKA L. CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
100 CENTURY DR, WORCESTER, MA 01606-1244
(508) 334-6392
(774) 441-6072
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
10246
MA
103TC0700X
Clinical Psychologist
10246
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
110118477A
MA
Enumeration date
08/18/2016
Last updated
11/21/2020
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