Provider Demographics
NPI:1972180289
Name:PARIS, CLARA ANN (COTA/R, CPHT)
Entity Type:Individual
Prefix:
First Name:CLARA
Middle Name:ANN
Last Name:PARIS
Suffix:
Gender:F
Credentials:COTA/R, CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 LARCH LN
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-7951
Mailing Address - Country:US
Mailing Address - Phone:410-382-8863
Mailing Address - Fax:
Practice Address - Street 1:1005 LARCH LN
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-7951
Practice Address - Country:US
Practice Address - Phone:410-382-8863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-24
Last Update Date:2021-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
T18758183700000X
429249224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
No183700000XPharmacy Service ProvidersPharmacy Technician