Linda Clark
Individual provider Active NPI Occupational Therapy Assistant · Summit, MS
NPI 1295056174 · NPPES record last updated Jun 15, 2010
Key facts
- NPI
- 1295056174
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- OTA200084 (LA)
- Practice address
- 4109 Highway 98 W
Summit, MS 39666-9132 - Phone
- (601) 276-3900
- NPI assigned
- Jun 15, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| OTA200084 | LA | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | OTA200084 | LA | Yes |
Addresses
Primary practice location
4109 Highway 98 W
Summit, MS 39666-9132
Mailing address
7726 Highway 165
Columbia, LA 71418-3322
Other providers in Summit, MS
- Ja'Nice J Carter
- Tony Channell
- Mattelyn C. Chatham
- Fernando Chong
- Jonalyn Clark
- Christy Cobb
- Thomas Chadwick Cochran
- Mitzi Cockrell
- Ann Marie Cole
- Kendria Coleman
All providers in Summit, MS · Occupational Therapy Assistant in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2010. 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.