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

Koletta Rae Clarke, COTA

Individual provider Occupational Therapy Assistant · NPI 1285924092

Koletta Rae Clarke, COTA is an Occupational Therapy Assistant in Mount Vernon, Illinois. Licensed in Illinois. Registered with an NPI since 2011.

Licensed in
IL
In the registry since
2011
What do these letters mean?
COTA — Certified Occupational Therapy Assistant
Delivers treatment under an occupational therapist's direction.

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Practice location Address checks out

208 Zachery Dr
Mount Vernon, IL 62864-6712
Phone: (618) 204-5497
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 057.003262 (IL)

Record details

NPI number1285924092
Entity typeIndividual (Type 1)
GenderFemale
Credentials COTA
Sole proprietorNo
NPI enumeratedApril 13, 2011
Last updated in NPPESApril 13, 2011

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