Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

De'Atra Pruett Clark, OT

Individual provider Occupational Therapist · NPI 1164427209

De'Atra Pruett Clark, OT is an Occupational Therapist in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2005.

Licensed in
FL
In the registry since
2005
What do these letters mean?
OT — Occupational Therapist
Helps people regain the skills needed for daily living and work.

See every abbreviation used in this directory →

Practice location Address checks out

1325 San Marco Blvd Ste 102
Jacksonville, FL 32207-8549
Phone: (904) 858-7045
Fax: (904) 858-7047
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence OT0007576 (FL)

Record details

NPI number1164427209
Entity typeIndividual (Type 1)
GenderFemale
Credentials OT
Sole proprietorNo
NPI enumeratedJune 16, 2005
Last updated in NPPESJuly 8, 2007

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