Individual
EMILIE I. CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTAL
Contact information
Practice address
4697 HARRISON ST, BELLAIRE, OH 43906-1338
(740) 671-1436
(740) 671-1210
Mailing address
4697 HARRISON ST, BELLAIRE, OH 43906-1338
(740) 671-1436
(740) 671-1210
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
C1276
WV
224Z00000X
Occupational Therapy Assistant
OP002386L
PA
224Z00000X
Occupational Therapy Assistant
Primary
OTA01904
OH
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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