Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 018084-1 | NY |
NPI | 1144660648 |
---|---|
Provider Name | Mrs. Britney Lynn Clark |
First Address | Wellsville, NY 14895-0072 |
Second Address | Wellsville, NY 14895-0072 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2013 |
Last Update Date | 27/02/2020 |