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Contact Information

NICOLE CLARK, COTA/L
1526 ATWOOD AVE STE 202
JOHNSTON, RI02919-3289
 Phone: 401-642-8080
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapy Assistant

224Z00000X
Indicates primary specialty

NPI Profile & details for NICOLE CLARK · (Female)

NPI Number 1184438475
Status Active
Credentials COTA/L (Licensed Certified Occupational Therapy Assistant )
Entity Individual
Enumeration date 02/05/2025
Last updated 02/05/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • RI License # OTA01080
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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