Melissa Sue Clark, OTR/L
Individual provider Active NPI Occupational Therapist · Blue Ridge, GA
NPI 1811228877 · NPPES record last updated Jan 14, 2010
Key facts
- NPI
- 1811228877
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- OT005037 (GA)
- Practice address
- 3798 E First St
Blue Ridge, GA 30513-4514 - Phone
- (706) 632-7168
- Fax
- (706) 632-9756
- NPI assigned
- Jan 14, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Function Junction Inc | Occupational Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT005037 | GA | Yes |
Addresses
Primary practice location
3798 E First St
Blue Ridge, GA 30513-4514
Mailing address
3798 E First St
Blue Ridge, GA 30513-4514
Phone (706) 632-7168
Other providers in Blue Ridge, GA
- Christopher Casey
- Jeremy Lee Chadwick
- Nancy Elizabeth Chancey
- Megan Cheatham
- Robert Cini
- Sarah Romines Cleckler
- Cochran Counseling Services, LLC
- Darlena Michelle Cochran
- Patricia Lynn Cochran
- Marlo Loraine Coker
All providers in Blue Ridge, GA · Occupational Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 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.