Individual
KIMBERLY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSC, COTA
Contact information
Practice address
804 WRIGHT ST, BRAINERD, MN 56401-4441
(218) 522-8288
Mailing address
34588 PEORIA RD, PEQUOT LAKES, MN 56472-2879
(816) 244-0933
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
202799
MN
Other
Enumeration date
05/15/2025
Last updated
05/15/2025
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