Kara Ann Clark, OTR

Individual provider Active NPI Occupational Therapist · Prairie Du Chien, WI

NPI 1548617848 · NPPES record last updated Nov 22, 2019

Key facts

NPI
1548617848
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
090394 (IA)
Practice address
219 S State St
Prairie Du Chien, WI 53821-1822
Phone
(262) 408-9312
NPI assigned
May 17, 2016
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

LicenseStateTypeSpecialty
090394IAMDOccupational Therapist
5850-26WIMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5850-26 WI
Occupational Therapist 225X00000X 090394 IA Yes

Addresses

Primary practice location

219 S State St
Prairie Du Chien, WI 53821-1822

Mailing address

219 S State St
Prairie Du Chien, WI 53821-1822
Phone (262) 408-9312

Other providers in Prairie Du Chien, WI

All providers in Prairie Du Chien, WI · Occupational Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.