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MRS. MELINDA VOGUIT CLARK OTR/L
>> Occupational Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1174750038
Individual Registrant:MRS. MELINDA VOGUIT CLARK OTR/L
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
4829 INNISBROOK CT S ELKTON, FL 32033-2067 US
Tel: 904-374-1414 Fax: --
Tel: 904-374-1414 Fax: --
Contact information for business:
4829 INNISBROOK CT S ELKTON, FL 32033-2067 US
Tel: 904-374-1414 Fax: --
Tel: 904-374-1414 Fax: --
Registration Information:
NPI: 1174750038
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Occupational Therapist | FL | OT13589 |
| N | 222Q00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Developmental Therapist |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 001078200 | FL | 05 | |
| 001078300 | FL | 05 |
