| Katie Lynne Clark, | |
|
2012 S Jones Blvd, Las Vegas, NV 89146-3151 | |
| (702) 360-1137 | |
| Not Available |
| Full Name | Katie Lynne Clark |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist |
| Location | 2012 S Jones Blvd, Las Vegas, Nevada |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164760369 | NPI | - | NPPES |
| 1164760369 | Medicaid | NV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225X00000X | Occupational Therapist | OT-2032 (Nevada) | Primary |
| Provider Name | Speakeasy Therapy Services Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1114315801 PECOS PAC ID: 3870867369 Enrollment ID: O20170921003383 |
| Mailing Address | Practice Location Address |
|---|---|
| Katie Lynne Clark, 283 Deerleap Cir, Henderson, NV 89052-2340 Ph: (702) 285-3153 | Katie Lynne Clark, 2012 S Jones Blvd, Las Vegas, NV 89146-3151 Ph: (702) 360-1137 |
Miss Sheila Acosta Marquez, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 4275 Burnham Ave, Ste. 225 Desert Springs Therapy Clinic, Las Vegas, NV 89119 Phone: 702-380-1060 Fax: 702-380-1081 | |
Farah Michelle Westreich, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 8000 Spring Mountain Rd, 2116, Las Vegas, NV 89117 Phone: 954-253-3739 | |
Alicia Marie Schwarz, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1525 E Windmill Ln, #202, Las Vegas, NV 89123 Phone: 702-434-6920 Fax: 702-361-8596 | |
Geoffrey Shih, OT Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 6161 W Charleston Blvd, Las Vegas, NV 89146 Phone: 702-468-8311 | |
Mrs. Kelly Jean Squire-hamblet, MSOTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 5540 Azuza Ave, Las Vegas, NV 89122 Phone: 702-348-9076 | |
Autism & Behavioral Consulting Services Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 7560 W Sahara Ave Ste 107, Las Vegas, NV 89117 Phone: 702-476-2633 Fax: 702-979-1028 | |
Tashia Kaplan, OTD, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 6375 W Charleston Blvd Bldg L, Las Vegas, NV 89146 Phone: 702-259-1903 |