Individual
CAROL SHELBY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1647 MALLORY LN, SUITE 103, BRENTWOOD, TN 37027-2909
(615) 661-5437
(615) 277-2838
Mailing address
926 LAWN VIEW LN, FRANKLIN, TN 37064-5566
(901) 299-0669
(615) 595-0812
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
3421
TN
225XP0200X
Pediatric Occupational Therapist
3421
TN
Other
Enumeration date
07/06/2006
Last updated
04/28/2009
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