Clark, Patricia R
Clark, Patricia R is an sole proprietor health care provider with primary practice located at 186 Kettle Pond Dr , Wakefield RI 02879-5419. She recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as her primary health care specialty. Clark, Patricia R can be contacted via phone (401) 789-7770.Contact Information
Primary practice address
186 Kettle Pond Dr
Wakefield RI 02879-5419
Phone: (401) 789-7770
Fax: (401) 783-3636
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 51 | Rhode Island |
Profile Details
| NPI number | 1720122963 |
|---|---|
| LBN Legal business name | Clark, Patricia R |
| Credentials | M.S., LMFT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 19th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1720122963 | NPPES |
| Rhode Island | Other | 7221-2 | BLUE CROSS & BLUE SHIELD |
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