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1023683703
LISA M CLARK
VIRGINIA BEACH, VA
NPI
1023683703
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: VA 0131002424)
Enumeration Date
2021-05-25
Last Update Date
2021-05-25
Business Address
LISA M CLARK
3100 SHORE DR
VIRGINIA BEACH, VA 23451-1199
Phone number: 757-496-1102
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Mailing Address
LISA M CLARK
2649 SPRINGHAVEN DR
VIRGINIA BEACH, VA 23456-3995
Phone number: 757-472-0241
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