| NPI | 1982849154 |
|---|---|
| Former Name | MARIAN LYNN CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: IL 057.002193) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: IA 00744) |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2008-12-02 |