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Individual

MRS. MELISSA LYNNE CLARKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR, MOT

Contact information

Practice address
1301 MEDICAL PKWY STE 130, CEDAR PARK, TX 78613-2529
(512) 248-2422
(512) 248-2354
Mailing address
9101 BURNET RD STE 103, AUSTIN, TX 78758-5260
(512) 248-2422
(512) 248-2354

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
225XP0200X
Pediatric Occupational Therapist
Primary
114267
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
294270803
TX
05
294270804
TX
Enumeration date
05/08/2012
Last updated
03/31/2019
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