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Contact Information

RACHEAL CLARK, PH.D., BCBA
6100 DAYLONG LN STE 103
CLARKSVILLE, MD21029-1631
 Phone: 410-531-8100
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for RACHEAL CLARK · (Female)

NPI Number 1124685805
Status Active
Credentials PH.D., BCBA
Entity Individual
Enumeration date 05/28/2019
Last updated 10/19/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • MD License # 06447
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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