Individual
JUDITH RENEE CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6001 WILORA LAKE RD, CHARLOTTE, NC 28212-2833
(704) 900-6072
Mailing address
6001 WILORA LAKE RD, CHARLOTTE, NC 28212-2833
(704) 900-6072
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
9278
NC
224Z00000X
Occupational Therapy Assistant
OTA13081
FL
Other
Enumeration date
07/08/2013
Last updated
10/07/2014
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