Individual
KEJA MARIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
901 JOSEPH KERWIN DR, LAS VEGAS, NV 89145-5944
(702) 918-3708
Mailing address
901 JOSEPH KERWIN DR, LAS VEGAS, NV 89145-5944
(702) 918-3708
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-2678
NV
Other
Enumeration date
05/26/2021
Last updated
05/26/2021
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