Individual
TIFFANY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
64 BRADFORD CIR, SUGAR LAND, TX 77479-2976
(281) 726-9471
Mailing address
64 BRADFORD CIR, SUGAR LAND, TX 77479-2976
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
214462
TX
Other
Enumeration date
10/28/2017
Last updated
10/28/2017
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