WANDA LOUISE CLARK (NPI# 1578764056) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578764056 |
| Entity Type | Individual |
| Full Name | WANDA LOUISE CLARK |
| Credential | OTA |
| Practice Address |
1422 San Marco Blvd Jacksonville FL 32207-8536 |
| Mailing Address |
1563 Harvest Cove Dr Middleburg FL 32068-6837 |
| Practice Telephone | 9043060177 |
| Mailing Telephone | 9044069239 |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224Z00000X | Occupational Therapy Assistant | OTA4733 | FL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356340681 | Wanda Lu Clark | Nurse Practitioner | 3113 Ross St, Amarillo, TX 79103-2700 | 2005-07-19 |
| 1043213457 | Wanda Kaye Clark | Nurse Practitioner | 1151 Camden Ave, Rock Hill, SC 29732-3014 | 2005-05-31 |
| 1588936447 | Wanda Clark | Case Manager/Care Coordinator | 1300 E Hanagita, Valdez, AK 99686-1635 | 2012-02-07 |
| 1376866301 | Wanda Mae Clark | Counselor | 116 S Lawrence St, Rockingham, NC 28379-3657 | 2010-03-04 |
| Street Address |
1422 SAN MARCO BLVD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-8536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952385825 | Jennifer Lynn Quaranto | Occupational Therapist | 1422 San Marco Blvd, Jacksonville, FL 32207-8536 | 2005-12-02 |
| 1982832978 | Michael Paul Kasimier | Physical Therapist | 1422 San Marco Blvd, Jacksonville, FL 32207-8536 | 2009-06-29 |
| 1356530695 | Paviella K Gomez | Physical Therapy Assistant | 1422 San Marco Blvd, Jacksonville, FL 32207-8536 | 2007-10-23 |
| 1427246537 | Robert Raymond Powell | Physical Therapist | 1422 San Marco Blvd, Jacksonville, FL 32207-8536 | 2007-10-15 |
| 1548456684 | Jermain Mcneel Tezeno | Physical Therapist | 1422 San Marco Blvd, Jacksonville, FL 32207-8536 | 2007-09-21 |
| 1861683757 | Keisha Dionne Engram | Physical Therapy Assistant | 1422 San Marco Blvd, Jacksonville, FL 32207-8536 | 2007-08-06 |
| 1881891141 | Carmenska Joisil | Physical Therapist | 1422 San Marco Blvd, 15204 West Colonial Dr. Winter Garden, Fl 32461, Jacksonville, FL 32207-8536 | 2007-06-29 |
| 1588868111 | Breenda Petropoulos | Occupational Therapy Assistant | 1422 San Marco Blvd, Jacksonville, FL 32207-8536 | 2007-06-14 |
| 1134323769 | Joe Petropoulos | Physical Therapy Assistant | 1422 San Marco Blvd, Jacksonville, FL 32207-8536 | 2007-06-14 |
| 1265635072 | Elisabeth Mcbee | Physical Therapy Assistant | 1422 San Marco Blvd, Jacksonville, FL 32207-8536 | 2007-06-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 224Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapy Assistant |
| An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examination for occupational therapy assistants, and fulfills state requirements for licensure, certification, or registration. An occupational therapy assistant provides interventions under the supervision of an occupational therapist which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy assistants address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, source changed] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184249344 | Michael Scott Slinkard | Occupational Therapy Assistant | 144 Caldwell St, Jacksonville, IL 62650-1810 | 2020-06-13 |
| 1134768708 | Stephanie Lee Mabus | Occupational Therapy Assistant | 873 Gorve St, Jacksonville, IL 62650 | 2019-12-31 |
| 1649817735 | Ayesha M Harris | Occupational Therapy Assistant | 13521 Stone Pond Dr, Jacksonville, FL 32224-1626 | 2019-12-08 |
| 1790340123 | Amanda Marie Mcbride | Occupational Therapy Assistant | 11239 Stoney Point Ln W, Jacksonville, FL 32257-4560 | 2019-05-01 |
| 1104395607 | Shawana D Smith | Occupational Therapy Assistant | 2496 West 28th St, Jacksonville, FL 32209-3220 | 2018-11-14 |
| 1770062788 | David Rentz | Occupational Therapy Assistant | 838 Brown St., Jacksonville, TX 75766 | 2018-08-09 |
| 1689175655 | Bryan Taylor Sanchez | Occupational Therapy Assistant | 5870 Fm 347 N, Jacksonville, TX 75766-6687 | 2018-02-26 |
| 1720599301 | Danielle Hughes | Occupational Therapy Assistant | 2749 Sebastian Ct, Jacksonville, FL 32224-3222 | 2017-10-23 |
| 1083157325 | Gloria Jiovani Malone | Occupational Therapy Assistant | 7945 Delta Post Dr S, Jacksonville, FL 32244-6834 | 2016-11-18 |
| 1255887923 | Zenebeworke Sheffield | Occupational Therapy Assistant | 6611 Rippling Wave Ct, Jacksonville, FL 32244-6876 | 2016-08-31 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.