Individual
DANIELLE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
13910 FIVAY RD STE 6, HUDSON, FL 34667-7130
(727) 869-9479
Mailing address
3901 UNIVERSITY BLVD S, JACKSONVILLE, FL 32216-4312
(904) 345-7336
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA12912
FL
Other
Enumeration date
08/18/2016
Last updated
08/18/2016
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