Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Justin Clark, BAHISTORY

Individual provider Developmental Therapist · NPI 1114360807

Justin Clark, BAHISTORY is a Developmental Therapist in Southern Pines, North Carolina. Registered with an NPI since 2013.

In the registry since
2013

Practice location Address checks out

1280 Central Dr
Southern Pines, NC 28387-2102
Phone: (910) 692-3323
Fax: (910) 692-1114
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Developmental Therapist (primary) Taxonomy 222Q00000X

Record details

NPI number1114360807
Entity typeIndividual (Type 1)
GenderMale
Credentials BAHISTORY
Sole proprietorNo
NPI enumeratedApril 11, 2013
Last updated in NPPESApril 11, 2013

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