Most Relevant Information
Provider Data
| NPI Number: | 1003545864 |
| Provider Name: | CANDICE CLARK |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/07/2022 |
| Last Updated: | 06/07/2022 |
Provider Practice Location
225 CEDAR HILL ST STE 200
MARLBOROUGH
MA
017525900
Practice Location Phone/Fax
| Phone: | 8774182978 |
| Fax: |
Provider Mailing Location
350 FAIRWAY DR STE 101
DEERFIELD BEACH
FL
334411834
Provider Mailing Phone/Fax
| Phone: | 8774182978 |
| Fax: | 8665002186 |