Kelly Lynn Clark

NPI #1124430772 in Lake Mary, Florida

Provider Information

NPI Number: 1124430772
Entity Type: Individual
Name: Kelly Lynn Clark
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: May 29, 2014
Last Updated: Jan 16, 2017

Practice Location

Address: 791 RINEHART RD
City: Lake Mary
State: Florida
ZIP Code: 32746-4876
Phone: (407) 413-9550

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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