Sheree Ann Clark, COTA/L

Individual provider Active NPI Occupational Therapy Assistant · Clay, KY

NPI 1942523634 · NPPES record last updated Mar 9, 2010

Key facts

NPI
1942523634
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
A1846 (KY)
Practice address
323 Diamond Green Grove Road
Clay, KY 42404
Phone
(270) 635-0789
NPI assigned
Mar 9, 2010
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
A1846KYMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X A1846 KY Yes

Addresses

Primary practice location

323 Diamond Green Grove Road
Clay, KY 42404

Mailing address

323 Diamond Green Grove Road
Clay, KY 42404
Phone (270) 635-0789

Other providers in Clay, KY

All providers in Clay, KY · Occupational Therapy Assistant in Kentucky

Sources for this page

Verify at the official NPI Registry.