Individual
ELYSSA F CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
270 E 8TH AVE STE 206, DURANGO, CO 81301-5708
(970) 769-0131
Mailing address
2003 E 2ND AVE, DURANGO, CO 81301-4629
(303) 968-4882
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-39650
CO
Other
Enumeration date
09/03/2019
Last updated
08/18/2020
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