Individual
JULIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3450 S 900 W, SOUTH SALT LAKE, UT 84119-4104
(385) 266-5818
Mailing address
3450 S 900 W, SOUTH SALT LAKE, UT 84119-4104
(385) 266-5818
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10800075-3503
UT
Other
Enumeration date
10/29/2019
Last updated
10/29/2019
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