Clark, Alice Ann
Clark, Alice Ann is an sole proprietor health care provider with primary practice located at 55 S Main St , Waterbury VT 05676-1556. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Clark, Alice Ann can be contacted via phone (802) 585-0297.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 7094 | Massachusetts |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 048.0057921 | Vermont |
Profile Details
| NPI number | 1598813073 |
|---|---|
| LBN Legal business name | Clark, Alice Ann |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 8th, 2007 |
| Last updated | Dec 1st, 2010 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1598813073 | NPPES |
| Massachusetts | Other | W06Z86 | BCBS |
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