Provider Demographics
NPI:1205314010
Name:CLINK, ELIZABETH (OT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:CLINK
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10609 W IH 10 STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-1673
Mailing Address - Country:US
Mailing Address - Phone:210-344-5437
Mailing Address - Fax:210-340-1259
Practice Address - Street 1:560 N EXPOSITION ST # C
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-5902
Practice Address - Country:US
Practice Address - Phone:316-618-1252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-02
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173913801Medicaid