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1528658879
JAMIE WALLACE CLARK
PORTLAND, ME
NPI
1528658879
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: ME OT2950)
Enumeration Date
2021-01-21
Last Update Date
2023-12-19
Business Address
JAMIE WALLACE CLARK MSOTR/L
959 CONGRESS ST
PORTLAND, ME 04102-2715
Phone number: 207-699-5600
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Mailing Address
JAMIE WALLACE CLARK MSOTR/L
1145 BRIGHTON AVE
PORTLAND, ME 04102-1075
Phone number: 207-541-6523
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