Melissa Newkam Clark
Occupational Therapist - Pediatrics
5745 Old Winder Hwy Ste C
Braselton
, Georgia 30517-1637
Melissa Newkam Clark
Occupational Therapist - Pediatrics
5745 Old Winder Hwy Ste C
Braselton
, Georgia 30517-1637
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About
Features
Specialties
- Occupational Therapist - Pediatrics
Languages spoken
- English
Location
First Address
- Melissa Newkam Clark
- 5745 Old Winder Hwy Ste C
- Braselton, GA
- Zip : 30517-1637
- Phone :
Second Address
- Melissa Newkam Clark
- 5745 Old Winder Hwy Ste C
- Braselton, GA
- Zip : 30517-1637
- Phone : (770) 965-1861
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225XP0200X | Occupational Therapist - Pediatrics | OT005376 | GA |
National Provider Identifier
| NPI | 1063799682 |
|---|---|
| Provider Name | Melissa Newkam Clark |
| First Address | Braselton, GA 30517-1637 |
| Second Address | Braselton, GA 30517-1637 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/11/2011 |
| Last Update Date | 10/11/2011 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.