Clark, Katie Lynne

Clark, Katie Lynne is an individual health care provider with primary practice located at 2012 S Jones Blvd , Las Vegas NV 89146-3151. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Clark, Katie Lynne can be contacted via phone (702) 360-1137.

Contact Information

Primary practice address
2012 S Jones Blvd Las Vegas NV 89146-3151
Phone: (702) 360-1137
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OT-2032 Nevada

Profile Details

NPI number 1164760369
LBN Legal business name Clark, Katie Lynne
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 22nd, 2013
Last updated Dec 9th, 2018 - about 8 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 1164760369 NPPES
Nevada MEDICAID 1164760369

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