Provider Demographics
NPI:1447040696
Name:CLARK, KAREN (OT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:CLARK
Suffix:
Gender:
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 LAKE SHORE DR N
Mailing Address - Street 2:
Mailing Address - City:WESTFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01886-1532
Mailing Address - Country:US
Mailing Address - Phone:978-828-1289
Mailing Address - Fax:
Practice Address - Street 1:50 NORRIS RD
Practice Address - Street 2:
Practice Address - City:TYNGSBORO
Practice Address - State:MA
Practice Address - Zip Code:01879-1228
Practice Address - Country:US
Practice Address - Phone:978-828-1289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-10
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist