Jameshia Clark
Individual provider Active NPI Occupational Therapy Assistant · Deland, FL
NPI 1154887743 · NPPES record last updated Feb 19, 2019
Key facts
- NPI
- 1154887743
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- OTA11953 (FL)
- Practice address
- 400 E Howry Ave
Deland, FL 32724-5400 - Phone
- (386) 822-6900
- NPI assigned
- Feb 19, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTA11953 | FL | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA11953 | FL | Yes |
Addresses
Primary practice location
400 E Howry Ave
Deland, FL 32724-5400
Mailing address
8477 S Suncoast Blvd
Homosassa, FL 34446-5028
Phone (352) 382-1141
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All providers in Deland, FL · Occupational Therapy Assistant in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.