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Contact Information

AMANDA CLARK, COTA
7146 BAHNE RD
FAIRVIEW, TN37062
 Phone: 615-418-5498
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapy Assistant

224Z00000X
Indicates primary specialty

NPI Profile & details for AMANDA CLARK · (Female)

NPI Number 1992257281
Status Active
Credentials COTA (Certified Occupational Therapy Assistant)
Entity Individual
Enumeration date 11/02/2016
Last updated 08/29/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • CO License # OTA.0001097
  • FL License # OTA16750
  • MT License # OTP-OTA-LIC-6114
  • TN License # 2598
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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