Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DERWIN CLARK
Active Sole ProprietorResidential Treatment, Emotionally Disturbed Children · LITTLE ROCK, AR
Registration Details
- NPI Number
- 1508231085
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 9, 2015 (10.367031731265 yrs)
- Last Updated
- Dec 9, 2015
- Sole Proprietor
- Yes
Practice Information
- Address
-
20400 COLONEL GLENN RDLITTLE ROCK, AR, 722105323Browse AR providers · Browse ZIP 72210
- Phone
- 5018215500
- Fax
- 5018215580
- Primary Specialty
-
Residential Treatment, Emotionally Disturbed Children
322D00000X
Other Residential Treatment, Emotionally Disturbed Children Providers in LITTLE ROCK, AR
| Name | Credential | NPI |
|---|---|---|
| KELANDA WILLIAMS | — | 1477928984 |
| FELICIA REYNOLDS-JOHNSON | — | 1932574431 |
| CEDRIC MAYO | — | 1104282235 |
| DAVID ZAJAC | — | 1437517844 |
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.