Carly A Clark, PSS

NPI #1689375529 in Gresham, Oregon

Provider Information

NPI Number: 1689375529
Entity Type: Individual
Name: Carly A Clark, PSS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Credential: PSS
Enumeration Date: Mar 16, 2023
Last Updated: Mar 16, 2023

Practice Location

Address: 620 NE 2ND ST
City: Gresham
State: Oregon
ZIP Code: 97030-7514
Phone: (971) 274-3757

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X
Peer Specialist	175T00000X	Primary

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