Individual
MS. PAMELA STACIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1900 SUMMIT BLVD, PENSACOLA, FL 32503
(850) 436-5900
Mailing address
2635 DANFORTH TER, WELLINGTON, FL 33414-3416
(561) 716-2506
(561) 784-7079
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA10423
FL
Other
Enumeration date
05/23/2007
Last updated
03/20/2008
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