Individual
DR. WILLIAM WALTER CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
2110 GALLOWS RD # B, VIENNA, VA 22182-3962
(703) 506-8378
(703) 893-1011
Mailing address
1514 THURBER ST, HERNDON, VA 20170-2565
(703) 904-9046
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810002215
VA
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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