Individual
MRS. MICHELLE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
6276 JACKIE AVE, WOODLAND HILLS, CA 91367-1422
(818) 439-7535
(818) 884-8674
Mailing address
6276 JACKIE AVE, WOODLAND HILLS, CA 91367-1422
(818) 439-7535
(818) 884-8674
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
721
CA
225XP0200X
Pediatric Occupational Therapist
721
CA
Other
Enumeration date
02/19/2012
Last updated
02/19/2012
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