# OT CLINICAL GROUP CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255303467
- **Authorized official:** MRS. DORIS VEGA VILLAVICENCIO MPH,OTR/L (PRESIDENTA)
- **Authorized official phone:** (787) 785-9683

## Contact information

- **Practice address:** SS3 CALLE 35, URB. SANTA JUANITA, BAYAMON, PR 00956-4748
- **Practice address phone:** (787) 785-9683
- **Practice address fax:** (787) 785-9683
- **Mailing address:** SS3 CALLE 35, URB. SANTA JUANITA, BAYAMON, PR 00956-4748
- **Mailing address phone:** (787) 785-9683
- **Mailing address fax:** (787) 785-9683

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225X00000X | Occupational Therapist | 422 | PR | Yes |

## Other

- **Enumeration date:** 02/02/2006
- **Last updated:** 07/02/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 890461 | MMM | PR |