Individual
KRISTINE JULIA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
809 N PATTERSON ST, VALDOSTA, GA 31601-4528
(229) 469-6932
(229) 469-6933
Mailing address
809 N PATTERSON ST, VALDOSTA, GA 31601-4528
(229) 469-6932
(229) 469-6933
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT008605
GA
Other
Enumeration date
11/07/2022
Last updated
01/29/2025
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