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General NPI Number Information
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NPI Number | 1992363857
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Entity Type | Organization
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Legal Business Name | KARA CLINELLC
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Dates
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Enumeration Date | 06/04/2019
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Last Update Date | 03/21/2023
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Provider Practice Location Address
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Address Line | 7075 GOLDEN OAKS LOOP W STE 2
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City | SOUTHAVEN
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State | MS
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Zip | 38671-9011
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Country | US
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Telephone | 870-514-7040
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Fax | 662-655-1331
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Provider Business Mailing Address
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Address Line | 3337 PECAN ESTATES LN
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City | HERNANDO
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State | MS
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Zip | 38632-7361
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Country | US
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Telephone | 870-514-7040
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KARA CLINE
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Credential |
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Telephone | 870-514-7040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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