Provider Demographics
NPI:1447072053
Name:CLARK-HURST, CALIN BRIANNE (OTD, OTR)
Entity type:Individual
Prefix:
First Name:CALIN
Middle Name:BRIANNE
Last Name:CLARK-HURST
Suffix:
Gender:F
Credentials:OTD, OTR
Other - Prefix:
Other - First Name:CALIN
Other - Middle Name:BRIANNE
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:2808 FOX MEADOW LANE
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-9346
Mailing Address - Country:US
Mailing Address - Phone:870-335-2240
Mailing Address - Fax:870-931-4457
Practice Address - Street 1:2808 FOX MEADOW LANE
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72404-9346
Practice Address - Country:US
Practice Address - Phone:870-335-2240
Practice Address - Fax:870-931-4457
Is Sole Proprietor?:No
Enumeration Date:2024-10-26
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty