Vidal Clark

NPI #1154727048 in Jamaica Plain, Massachusetts

Provider Information

NPI Number: 1154727048
Entity Type: Individual
Name: Vidal Clark
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor
Enumeration Date: Nov 5, 2014
Last Updated: Nov 5, 2014

Practice Location

Address: 555 AMORY ST
Address 2: SUITE 3
City: Jamaica Plain
State: Massachusetts
ZIP Code: 02130-2652
Phone: (617) 522-0900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X	Primary

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