Individual
KATIE ELLEN CLEMENTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
520 S HULL ST, MONTGOMERY, AL 36104-4610
(334) 834-2920
Mailing address
520 S HULL ST, MONTGOMERY, AL 36104-4610
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5130
AL
Other
Enumeration date
01/28/2020
Last updated
01/28/2020
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