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General NPI Number Information
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NPI Number | 1720992910
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Entity Type | Individual
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Provider Name | ANSON LEIGH CLARK RBT
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Gender | Female
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Dates
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Enumeration Date | 10/02/2026
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Last Update Date | 10/02/2026
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Provider Practice Location Address
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Address Line | 1440 N ST NW STE A1
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City | WASHINGTON
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State | DC
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Zip | 20005-2817
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Country | US
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Telephone | 202-588-1112
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Fax |
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Provider Business Mailing Address
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Address Line | 209 INDIGO BAY CIR
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-3973
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Country | US
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Telephone | 843-830-0486
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-25-441674
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License Number State | DC
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