Individual
MRS. NICOLE CRAVEN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
311 W PHIFER ST, MARSHVILLE, NC 28103-1322
(704) 624-6643
Mailing address
311 W PHIFER ST, MARSHVILLE, NC 28103-1322
(704) 624-6643
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
14031
FL
225X00000X
Occupational Therapist
Primary
7089
NC
Other
Enumeration date
02/12/2010
Last updated
01/01/2018
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