Individual
HEAVEN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
919 STOKES ST, BURLINGTON, NC 27215-6537
(704) 450-3749
Mailing address
PO BOX 73, MOORESVILLE, NC 28115-0073
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13518
NC
Other
Enumeration date
12/02/2024
Last updated
06/11/2025
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