Individual provider · Type 1 NPI

Justin Clark, BA HISTORY

Developmental Therapist · Southern Pines, NC

NPI number 1114360807 Active

Practice location

1280 Central Dr
Southern Pines, NC 28387-2102

Call (910) 692-3323 Map

Fax (910) 692-1114

Specialties and licenses

TaxonomyCodeLicense
Developmental Therapist Primary 222Q00000XNone listed

Developmental Therapist: A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by completion of education experiences as approved by the state and practicing within the scope of that credential or, where state credentialing does not exist, certified by the Board of the Deve…

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About NPI 1114360807

Justin Clark, BA HISTORY's National Provider Identifier is 1114360807, issued on Apr 11, 2013. The primary taxonomy on file is Developmental Therapist (222Q00000X), and the practice location is in Southern Pines, NC. The record was last updated on Apr 11, 2013.