Mr. John E Clark III
Mr. John E Clark III is an Addiction (Substance Use Disorder) Counselor in Fairfax, Virginia. Licensed in Virginia. Registered with an NPI since 2007.
- Licensed in
- VA
- In the registry since
- 2007
Practice location Address checks out
10390 Democracy LnFairfax, VA 22030-2522
Phone: (703) 219-2578
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Specialties & licences
| Addiction (Substance Use Disorder) Counselor (primary) | Taxonomy 101YA0400X · Licence 0710101131 (VA) |
|---|
Record details
| NPI number | 1699824763 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | January 9, 2007 |
| Last updated in NPPES | July 8, 2007 |
| Mailing address | 11561 Shadbush Ct, Reston, VA 20191-3009 |
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