Individual
TAMMY W CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
386 BELAIRE DR, HIAWASSEE, GA 30546-3313
(706) 896-2231
Mailing address
199 WHITTEMORE ST, RINGGOLD, GA 30736-2518
(404) 698-8228
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001622
GA
Other
Enumeration date
04/20/2023
Last updated
04/20/2023
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