Individual
JAMIE L. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3611 W GRAY ST, TAMPA, FL 33609-1313
(614) 975-6475
Mailing address
18288 N US HWY 41, LUTZ, FL 33549
(813) 527-9638
(813) 867-7288
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT17030
FL
225XP0200X
Pediatric Occupational Therapist
008500
OH
Other
Enumeration date
02/14/2015
Last updated
11/17/2022
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