Individual
BRENNAN NALIYAH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13 NORTHTOWN DR STE 110, JACKSON, MS 39211-3047
(601) 206-9195
(601) 957-8391
Mailing address
13 NORTHTOWN DR STE 110, JACKSON, MS 39211-3047
(601) 206-9195
(601) 957-8391
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA4092
MS
Other
Enumeration date
09/24/2025
Last updated
09/24/2025
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