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Individual

CEZANNE OSANA CLARKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
2540 WIGGINS ST STE E, LITHONIA, GA 30058-4312
(404) 606-3755
Mailing address
524 HILLANDALE PARK DR, LITHONIA, GA 30058-8833
(860) 532-8947

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
121601
TX
225X00000X
Occupational Therapist
Primary
OT008489
2279H0200X
Home Health Registered Respiratory Therapist
121601
TX

Other

Enumeration date
05/21/2021
Last updated
04/13/2023
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