Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | OT19839 | CA |
Y | 225XH1200X | Occupational Therapist - Hand | 2199 | NV |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1205494275 |
---|---|
Provider Name | Ms. Victoria Clark |
First Address | Reno, NV 89509-3683 |
Second Address | Reno, NV 89509-3683 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2019 |
Last Update Date | 05/08/2021 |