Individual
CLARISSE MARIE CHADWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
71 N 490 W, AMERICAN FORK, UT 84003-2264
(801) 763-7775
Mailing address
71 N 490 W, AMERICAN FORK, UT 84003-2264
(801) 763-7775
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
5142103-6004
UT
101YA0400X
Addiction (Substance Use Disorder) Counselor
5142103-6004
UT
101YM0800X
Mental Health Counselor
5142103-6004
UT
101YP2500X
Professional Counselor
5142103-6004
UT
Other
Enumeration date
02/08/2008
Last updated
02/08/2008
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