Individual
MRS. ANGELIQUE CLARK-MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1227 GOSS AVE, LOUISVILLE, KY 40217-1239
(502) 636-1200
(502) 636-0351
Mailing address
1227 GOSS AVE, LOUISVILLE, KY 40217-1239
(502) 636-1200
(502) 636-0351
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
R2290
KY
Other
Enumeration date
10/16/2006
Last updated
07/08/2007
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