Individual
TERESA M CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
301 HIGHWAY 65 S, MORA, MN 55051-1899
(320) 225-3356
(320) 225-3370
Mailing address
19302 FRIESLAND RD, HINCKLEY, MN 55037-4768
(320) 225-3356
(320) 225-3370
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
103264
MN
225X00000X
Occupational Therapist
3919-26
WI
Other
Enumeration date
08/26/2014
Last updated
08/26/2014
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