Koletta Rae Clarke, COTA
NPI #1285924092 in Mount Vernon, Illinois
Provider Information
- NPI Number
- 1285924092
- Entity Type
- Individual
- Name
- Koletta Rae Clarke, COTA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Occupational Therapy Assistant
- Credential
- COTA
- Enumeration Date
- Apr 13, 2011
- Last Updated
- Apr 13, 2011
Practice Location
- Address
- 208 ZACHERY DR
- City
- Mount Vernon
- State
- Illinois
- ZIP Code
- 62864-6712
- Phone
- (618) 204-5497
Specialties & Taxonomy Codes
| Specialty |
|---|
| Occupational Therapy Assistant |
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