Individual
KELCI CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19 WHITE PINE RD STE C, HERMON, ME 04401-0258
(207) 355-1550
Mailing address
16 HIGGINS DR, HERMON, ME 04401-0239
(207) 944-9395
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OA4528
ME
Other
Enumeration date
08/08/2025
Last updated
08/08/2025
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