Individual
MRS. TESS CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
74 BRIDGE ST, NEWTON, MA 02458-1147
(617) 969-4410
(617) 969-4412
Mailing address
50 MYSTIC ST # 1, CHARLESTOWN, MA 02129-1916
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
11175
MA
Other
Enumeration date
03/21/2014
Last updated
03/29/2017
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