Clark, Terrell A
Clark, Terrell A is an individual health care provider with primary practice located at 9 Hope Ave , Waltham MA 02453-2741. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as her primary health care specialty. Clark, Terrell A can be contacted via phone (781) 216-2200.Contact Information
Primary practice address
9 Hope Ave
Waltham MA 02453-2741
Phone: (781) 216-2200
Fax: (781) 647-8914
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | 2856 | Massachusetts |
Profile Details
| NPI number | 1043283724 |
|---|---|
| LBN Legal business name | Clark, Terrell A |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 11th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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