Individual
LISA LYNN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
85 LUNT RD, BRUNSWICK, ME 04011-7289
(207) 729-0022
Mailing address
85 LUNT RD., BRUNSWICK, ME 04011
(207) 729-0022
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
000136
ME
Other
Enumeration date
11/06/2009
Last updated
11/06/2009
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