Individual
OLIVIA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2905 BEARCREEK CT, FULLERTON, CA 92835-3143
(951) 662-6479
Mailing address
2905 BEARCREEK CT, FULLERTON, CA 92835-3143
(951) 662-6479
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5365
CA
Other
Enumeration date
08/18/2020
Last updated
08/31/2020
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