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

Jacob C Clark

Individual provider Occupational Therapy Assistant · NPI 1205468006

Jacob C Clark is an Occupational Therapy Assistant in Detroit, Michigan. Licensed in Michigan. Registered with an NPI since 2020.

Licensed in
MI
In the registry since
2020

Practice location Address checks out

7800 W Outer Dr Ste 300
Detroit, MI 48235-3458
Phone: (313) 340-4442
Show map & directions

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

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 52002008500 (MI)

Record details

NPI number1205468006
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedFebruary 10, 2020
Last updated in NPPESFebruary 10, 2020
Certification dateFebruary 10, 2020
Mailing address27085 Gratiot Ave Ste 101, Roseville, MI 48066-2984

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