Individual
JANE S. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
24724 S BUSINESS 52, ALBEMARLE, NC 28001-8179
(704) 986-0862
Mailing address
24724 S BUSINESS 52, ALBEMARLE, NC 28001-8179
(704) 986-0862
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3135
NC
Other
Enumeration date
11/28/2012
Last updated
11/28/2012
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