DE'ATRA PRUETT CLARK OT
NPI 1164427209
Occupational Therapist in Jacksonville, FL

Active since June 16, 2005
1325 SAN MARCO BLVD, STE 102, JACKSONVILLE, FL 32207(904) 858-7045(904) 858-7047 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About De'atra Pruett Clark Ot NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DE'ATRA PRUETT CLARK OT (NPI 1164427209) is an individual occupational therapist in Jacksonville, Florida, licensed in Florida (OT0007576) and active in the NPI registry since June 2005.

NPPES Registry Identity

NPI1164427209
Entity TypeIndividualFemale
Primary Taxonomy225X00000X
Provider Legal NameDE'ATRA PRUETT CLARKCredential: OT
Location Address1325 SAN MARCO BLVD, STE 102Jacksonville, FL 32207-8549
Mailing Address1325 San Marco Blvd, Suite 701Jacksonville, FL 32207-8568 · (904) 858-6418 · Fax (904) 858-6490
Fax(904) 858-7047
Sole ProprietorNo
Enumeration DateJune 16, 2005
Last NPPES UpdateJuly 8, 2007
NPI 1164427209 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOccupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225X00000X
License Licensed in FL · OT0007576
Definition

An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.

1325 SAN MARCO BLVD, Jacksonville, FL 32207

Accepted Insurance

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Physical Therapist
1325 SAN MARCO BLVD, STE 102
JACKSONVILLE, FL 32207
Pharmacist
1325 SAN MARCO BLVD, SUITE 103
JACKSONVILLE, FL 32207
Specialist/Technologist (Athletic Trainer)
1325 SAN MARCO BLVD, #102
JACKSONVILLE, FL 32207
Specialist/Technologist (Athletic Trainer)
1325 SAN MARCO BLVD, #102
JACKSONVILLE, FL 32207
Specialist/Technologist (Athletic Trainer)
1325 SAN MARCO BLVD, #102
JACKSONVILLE, FL 32207
Clinic/Center (Medical Specialty)
1325 SAN MARCO BLVD, SUITE 301
JACKSONVILLE, FL 32207
Specialist/Technologist (Athletic Trainer)
1325 SAN MARCO BLVD, # 102
JACKSONVILLE, FL 32207
Occupational Therapist
1325 SAN MARCO BLVD, SUITE 102
JACKSONVILLE, FL 32207

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is De'atra Clark's NPI number?

The NPI number for De'atra Clark is 1164427209. It was assigned to this individual provider in the NPPES registry on June 16, 2005.

Where is De'atra Clark located?

De'atra Clark practices at 1325 San Marco Blvd Ste 102, Jacksonville, FL 32207. The listed phone number is (904) 858-7045.

What is De'atra Clark's specialty?

The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.

What insurance does De'atra Clark accept?

Health plans from AvMed and Oscar Health Maintenance Organization of Florida list De'atra Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for De'atra Clark was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.