Audrey Michele Clerk, M.S.,OTRL

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

112040 Issued in TX

Practice address

4443 N Josey LN
Suite 100
Carrollton, TX 75010-4743

Phone

(972) 939-3908

Fax

(972) 939-3939

NPI assigned

May 17, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1861609109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 WOLF DR",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751151731",
            "telephone_number": "901-496-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4443 N JOSEY LN",
            "address_2": "SUITE 100",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750104743",
            "telephone_number": "972-939-3908",
            "fax_number": "972-939-3939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLERK",
        "first_name": "AUDREY",
        "middle_name": "MICHELE",
        "name_prefix": "Miss",
        "credential": "M.S.,OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "112040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Classic Clinical Laboratory LLC
• Clearview Primary Care PLLC
• Ashley Elizabeth Cleary, DC
• Emma Clement
• Mary Haley Clement, MS SLP
• Clinger Enterprises Inc
• Clinica Guadalupe Carrolton LLC
• Clinica HF Josey Lane LLC
• Noelle Marie Cloward, LCSW
• CMM Medical Management, LLC

• Pediatric Occupational Therapist in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Pediatric Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.