IndividualActive
Brennan Clark
NPI 1992678288 · Occupational Therapy Assistant · Jackson, MS
Provider details
- NPI number
- 1992678288
- Entity type
- Individual
- Primary specialty
- Occupational Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- OTA4092 (MS)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
13 Northtown Dr Ste 110
Jackson, MS 39211-3047
Phone: (601) 206-9195
Fax: (601) 957-8391
Approximate (ZIP-level) locationGet directions
Mailing address
13 Northtown Dr Ste 110
Jackson, MS 39211-3047
Registry dates
- Enumerated
- 2025-09-24
- Last updated
- 2025-09-24
- Certified
- 2025-09-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.