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1740325778
MARY MARTHA CLARK
MAPLEWOOD, MN
NPI
1740325778
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Former Name
MARY MARTHA RIELAND
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225XP0200X Occupational Therapist, Pediatrics
(Licence: MN 100082)
Enumeration Date
2007-02-20
Last Update Date
2009-03-25
Business Address
-- MARY MARTHA CLARK OTR-L
2495 MAPLEWOOD DRIVE SUITE 313
MAPLEWOOD, MN 55109-1913
Phone number: 651-770-8884
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Mailing Address
-- MARY MARTHA CLARK OTR-L
616 PARK ST
ANOKA, MN 55303-1932
Phone number: 763-323-1336
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