Deanna Lynn Clark
Developmental Therapist in Riverview, FL. Individual provider (NPI-1).
NPI number1083463459
StatusActive
Last updated in NPPESMay 16, 2024
Details
- NPI
- 1083463459
- Entity type
- Individual (NPI-1)
- Name
- Deanna Lynn Clark
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 16, 2024
- Certification date
- May 16, 2024
- Last updated
- May 16, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 222Q00000X | Developmental Therapist | – | – | Yes |
Practice location
7243 Us Highway 301 S Ste ARiverview, FL 33578-8399
Phone 813-677-5471 · Fax 813-663-9828
Mailing address
2731 Crosby RdValrico, FL 33594-6771
Phone 813-732-0332
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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- Jennifer Jh LuttrellNPI 1629508809
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All 17 Developmental Therapist providers in Riverview · All 2,538 providers in Riverview
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