Individual
STEPHANIE W. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
6635 LAKE DR, MORROW, GA 30260-2354
(678) 422-4300
(678) 422-4299
Mailing address
6635 LAKE DR, MORROW, GA 30260-2354
(678) 422-4300
(678) 422-4299
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT001572
GA
Other
Enumeration date
09/26/2007
Last updated
09/26/2007
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