Individual
AIYANA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 26TH ST NW APT 6110, 6110, ATLANTA, GA 30309-1929
(804) 304-9142
Mailing address
220 26TH ST NW APT 6110, 6110, ATLANTA, GA 30309-1929
(804) 304-9142
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
09/23/2024
Last updated
09/23/2024
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