Individual
SYLVIA E CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
605 N UNION ST, WINONA, MS 38967-1718
(662) 428-9090
Mailing address
605 N UNION ST, WINONA, MS 38967-1718
(662) 428-9090
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA1511
MS
Other
Enumeration date
01/26/2007
Last updated
11/05/2013
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