Clark, Marion Sharon

Clark, Marion Sharon is an individual health care provider with primary practice located at 1025 N Country Club Dr , Mesa AZ 85201-3307. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant, which is considered as her primary health care specialty. Clark, Marion Sharon can be contacted via phone (480) 472-6162.

Contact Information

Primary practice address
1025 N Country Club Dr Mesa AZ 85201-3307
Phone: (480) 472-6162
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapy Assistant 224Z00000X 0086 Arizona

Profile Details

NPI number 1275681124
LBN Legal business name Clark, Marion Sharon
Credentials COTAL
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275681124 NPPES
Arizona MEDICAID 580242

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