Individual provider · Type 1 NPI

Koletta Rae Clarke, COTA

Occupational Therapy Assistant · Mount Vernon, IL

NPI number 1285924092 Active

Practice location

208 Zachery Dr
Mount Vernon, IL 62864-6712

Call (618) 204-5497 Map

Mailing address

13907 N Dartmouth Ln
Mount Vernon, IL 62864-9823

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapy Assistant Primary 224Z00000X057.003262 (IL)

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 examinatio…

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About NPI 1285924092

Koletta Rae Clarke, COTA's National Provider Identifier is 1285924092, issued on Apr 13, 2011. The primary taxonomy on file is Occupational Therapy Assistant (224Z00000X), and the practice location is in Mount Vernon, IL. The record was last updated on Apr 13, 2011.