DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. DOUGLASS BURNS CLARK, M.DIV

Active Sole Proprietor

Marriage & Family Therapist · CANAAN, NY

Registration Details

NPI Number
1386470789
Provider Type
Individual
Gender
Male
NPI Issued
Sep 11, 2024 (1.618618694311 yrs)
Last Updated
Sep 11, 2024
License
000546 (NY)
Sole Proprietor
Yes

Practice Information

Address
1559 COUNTY ROUTE 5
CANAAN, NY, 12029
Browse NY providers · Browse ZIP 12029
Phone
9179682493
Primary Specialty
Marriage & Family Therapist
106H00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.