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Individual

JENNY L. CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
879 E 1259 RD, LAWRENCE, KS 66047-9201
(785) 331-0667
Mailing address
879 E 1259 RD, LAWRENCE, KS 66047-9201

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
17-00516
KS

Other

Enumeration date
03/19/2007
Last updated
09/29/2010
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