Individual
ELEASHA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
673 BROOKHAVEN CT, APT 201, SPRINGDALE, AR 72764-6170
(906) 281-2271
Mailing address
673 BROOKHAVEN CT, APT 201, SPRINGDALE, AR 72764-6170
(479) 750-2020
(479) 750-8967
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OT2016-002
AR
Other
Enumeration date
06/10/2011
Last updated
01/25/2016
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