Individual provider · NPI-1

Ashley Clark, RBT

Behavior Technician · Dumfries, VA

NPI number1003577040
StatusActive
Last updated in NPPESJan 3, 2022

Details

NPI
1003577040
Entity type
Individual (NPI-1)
Name
Ashley Clark
Credential
RBT
Sex
Female
Sole proprietor
No
Enumeration date
Jan 3, 2022
Certification date
Jan 3, 2022
Last updated
Jan 3, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
106S00000X Behavior Technician––Yes

Practice location

17932 Fraley Blvd Ste 205
Dumfries, VA 22026-2456

Phone 703-229-4216

Mailing address

17932 Fraley Blvd Ste 205
Dumfries, VA 22026-2456

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