Individual
CARA LEANNE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
30801 JEFFERSON AVE, SAINT CLAIR SHORES, MI 48082-1732
(586) 293-1234
Mailing address
15708 HUNTCLIFF DR, MACOMB, MI 48044-3854
(586) 293-1234
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201008898
MI
Other
Enumeration date
01/14/2015
Last updated
02/01/2017
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