Individual
VALENSIA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2828 GREEN POND CIR, CONWAY, SC 29527-5143
(803) 439-8203
Mailing address
2828 GREEN POND CIR, CONWAY, SC 29527-5143
(803) 439-8203
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3462
SC
224ZE0001X
Environmental Modification Occupational Therapy Assistant
3462
SC
Other
Enumeration date
08/27/2015
Last updated
08/06/2024
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