Most Relevant Information
Provider Data
| NPI Number: | 1003577040 |
| Provider Name: | ASHLEY CLARK RBT |
| Entity Type: | Individual |
| Taxonomy Code: | 106S00000X |
| Specialty: | Behavior Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/03/2022 |
| Last Updated: | 01/03/2022 |
Provider Practice Location
17932 FRALEY BLVD STE 205
DUMFRIES
VA
220262456
Practice Location Phone/Fax
| Phone: | 7032294216 |
| Fax: |
Provider Mailing Location
17932 FRALEY BLVD STE 205
DUMFRIES
VA
220262456
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |