Individual
CLINTON JACE HARDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1300 E CENTER ST, PROVO, UT 84606-3554
(801) 344-4400
Mailing address
PO BOX 270, PROVO, UT 84603-0270
(801) 344-4400
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10376669-3501
UT
Other
Enumeration date
06/26/2015
Last updated
12/13/2019
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