VIDAL CLARK NPI 1154727048

NPI Information

Vidal Clark is a counselor in Jamaica Plain, MA. The provider is a provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification. Vidal Clark NPI is 1154727048. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

555 AMORY ST
SUITE 3
JAMAICA PLAIN, MA
ZIP 02130-652
Phone: (617) 522-0900

The enumeration date for this NPI number is 11/5/2014 and was last updated on 11/5/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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