Elyssa F Clark, BCBA
Behavior Analyst in Durango, CO. Individual provider (NPI-1).
NPI number1972151900
StatusActive
Last updated in NPPESAug 18, 2020
Details
- NPI
- 1972151900
- Entity type
- Individual (NPI-1)
- Name
- Elyssa F Clark
- Credential
- BCBA
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 3, 2019
- Certification date
- Aug 18, 2020
- Last updated
- Aug 18, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103K00000X | Behavior Analyst | 1-19-39650 | CO | Yes |
Practice location
270 E 8th Ave Ste 206Durango, CO 81301-5708
Phone 970-769-0131
Mailing address
2003 E 2nd AveDurango, CO 81301-4629
Phone 303-968-4882
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