Individual
MS. NICOLE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1526 ATWOOD AVE STE 202, JOHNSTON, RI 02919-3289
(401) 642-8080
Mailing address
5 SCOTT DR, RIVERSIDE, RI 02915-2617
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA01080
RI
Other
Enumeration date
02/05/2025
Last updated
02/05/2025
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