Jackie Clark
Jackie Clark is an Occupational Therapist in Private Practice in Parrish, Florida. Qualified in 2010, 16 years ago. Accepts Medicare assignment. Licensed in Florida.
- Years since qualifying
- 16
- Licensed in
- FL
- In the registry since
- 2016
Practice location Address checks out
11472 Walden LoopParrish, FL 34219-7565
Phone: (941) 806-7555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Occupational Therapist (primary) | Taxonomy 225X00000X · Licence OT14395 (FL) |
|---|
Record details
| NPI number | 1124474457 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | May 5, 2016 |
| Last updated in NPPES | December 6, 2016 |
| Mailing address | 11472 Walden Loop, Parrish, FL 34219-7565 |
Medicare enrollment
| Medicare specialty | OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE |
|---|---|
| Medical school | OTHER |
| Graduated | 2010 (16 years in practice) |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
Other providers in Parrish
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Back to Body Basics LLC
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Mrs. Jyoti Gupta
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Chelsy Ann Hendrix
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Lawrence Allen Henry, OTR/L
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-
Brittney Leibham
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