Individual
THERESA RENEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4000 FOXHOUND DR, LAFAYETTE HILL, PA 19444-1014
(215) 402-8500
Mailing address
3067 DAVENPORT WAY, PENNSBURG, PA 18073-1286
(267) 441-6179
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP010353
PA
Other
Enumeration date
06/12/2023
Last updated
06/12/2023
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