Individual
MRS. DEBORAH R CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
310 NORTH 9TH STREET, BISMARCK, ND 58502
(701) 530-8742
Mailing address
PO BOX 1397, 310 NORTH 9TH STREET, BISMARCK, ND 58502-1397
(701) 530-8742
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
729
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
747983
—
AZ
Enumeration date
12/09/2005
Last updated
07/08/2007
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