Individual
MISS AUDREY MICHELE CLERK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.,OTRL
Contact information
Practice address
4443 N JOSEY LN, SUITE 100, CARROLLTON, TX 75010-4743
(972) 939-3908
(972) 939-3939
Mailing address
1313 WOLF DR, DESOTO, TX 75115-1731
(901) 496-4231
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
112040
TX
Other
Enumeration date
05/17/2007
Last updated
01/29/2009
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