Individual
MRS. GRETCHEN MARIE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
15204 W COLONIAL DR, WINTER GARDEN, FL 34787-6042
(407) 877-2394
Mailing address
4020 GREENLEAF DR, KISSIMMEE, FL 34744-9150
(856) 904-8521
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 12485
FL
Other
Enumeration date
01/25/2012
Last updated
01/25/2012
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