Individual
ALYSSA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
358 S 700 E STE B307, SALT LAKE CITY, UT 84102-2161
(801) 935-5796
Mailing address
358 S 700 E STE B307, SALT LAKE CITY, UT 84102-2161
(801) 935-5796
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/04/2018
Last updated
06/04/2018
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