Clark, Terrell A

Clark, Terrell A is an individual health care provider with primary practice located at 9 Hope Ave , Waltham MA 02453-2741. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as her primary health care specialty. Clark, Terrell A can be contacted via phone (781) 216-2200.

Contact Information

Primary practice address
9 Hope Ave Waltham MA 02453-2741
Phone: (781) 216-2200
Fax: (781) 647-8914
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X 2856 Massachusetts

Profile Details

NPI number 1043283724
LBN Legal business name Clark, Terrell A
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 11th, 2006
Last updated Jul 8th, 2007 - about 17 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.

Request for update

Popular Providers