Individual ProviderDishon ClarkBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address225 Cedar Hill St Ste 200, Marlborough, MA 01752-5900(850) 510-6013PECOS EnrollmentBased on the most recent information from CMS, provider Dishon Clark does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1003447616Provider TypeIndividualFull NameClark, DishonGenderMaleSole ProprietorNoEnumeration Date2/1/2020Last Updated2/1/2020Contact InformationPractice LocationPractice Address225 Cedar Hill St Ste 200, Marlborough, MA 01752-5900Phone(850) 510-6013FaxUnlisted FaxMailing LocationMailing Address255 Honeysuckle Cir Apt 609, Lawrenceville, GA 30046-3223PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer