Jordan Amanda Clark, RBT
Behavior Technician in Springfield, VA. Individual provider (NPI-1).
NPI number1265202170
StatusActive
Last updated in NPPESJan 3, 2024
Details
- NPI
- 1265202170
- Entity type
- Individual (NPI-1)
- Name
- Jordan Amanda Clark
- Credential
- RBT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 3, 2024
- Certification date
- Jan 3, 2024
- Last updated
- Jan 3, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106S00000X | Behavior Technician | – | – | Yes |
Practice location
6216 Old Keene Mill CtSpringfield, VA 22152-2323
Phone 571-297-4308 · Fax 703-992-0405
Mailing address
6216 Old Keene Mill CtSpringfield, VA 22152-2323
Phone 571-297-4308 · Fax 703-992-0405
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