Individual
SHAY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APC
Contact information
Practice address
1258 W SOUTH JORDAN PKWY, SOUTH JORDAN, UT 84095-4711
(801) 255-1155
Mailing address
350 WOOD DR, ALPINE, UT 84004-2604
(801) 372-7849
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
80827886009
UT
Other
Enumeration date
02/11/2013
Last updated
02/11/2013
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