Individual
BRENNA ALYSE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
20650 GLENN ST, ELKHORN, NE 68022-2324
(402) 960-0932
Mailing address
7110 N 153RD CIR, BENNINGTON, NE 68007-1409
(402) 960-0932
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2632
NE
Other
Enumeration date
08/03/2022
Last updated
09/28/2023
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