Provider Demographics
NPI:1215218029
Name:CLARK, SARAH SCALIA (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:SCALIA
Last Name:CLARK
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 PLEASANTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-7072
Mailing Address - Country:US
Mailing Address - Phone:501-247-0218
Mailing Address - Fax:
Practice Address - Street 1:130 BROCKINGTON RD
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:AR
Practice Address - Zip Code:72120-3635
Practice Address - Country:US
Practice Address - Phone:501-819-0553
Practice Address - Fax:501-819-0518
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR2442225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist