Individual
JENNIFER MARIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1350 RIVER RUN DR, WISCONSIN RAPIDS, WI 54494-5487
(715) 421-7130
Mailing address
2610 CHASE ST, WISCONSIN RAPIDS, WI 54495-2240
(715) 712-0743
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2046-027
WI
Other
Enumeration date
08/01/2008
Last updated
09/26/2025
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