Individual
CAITLIN TONIA CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
145 S MAIN ST, BOUNTIFUL, UT 84010-6265
(801) 935-4171
(801) 935-4946
Mailing address
541 LACEY WAY, NORTH SALT LAKE, UT 84054-1530
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
8710931-2506
UT
106S00000X
Behavior Technician
RBT-21-181046
UT
Other
Enumeration date
09/09/2021
Last updated
10/06/2023
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