Individual
KAILA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
9150 W INDIAN SCHOOL RD STE 105, PHOENIX, AZ 85037-2385
(480) 787-5387
Mailing address
15801 W MONTECITO AVE, GOODYEAR, AZ 85395-7791
(763) 258-6693
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTH-008520
AZ
Other
Enumeration date
07/30/2021
Last updated
07/30/2021
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