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Individual

REBECCA CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
2220 S WALDRON RD # 57, FORT SMITH, AR 72903-3733
(479) 434-2371
Mailing address
2220 S WALDRON RD, FORT SMITH, AR 72903-3733

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OT2022-029
AR
225700000X
Massage Therapist
Primary
9293
AR

Other

Enumeration date
02/08/2023
Last updated
03/07/2024
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