Individual
JENNIFER ELAINE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1875 S GENEVA RD, OREM, UT 84058-2217
(801) 506-6695
Mailing address
1875 S GENEVA RD, OREM, UT 84058-2217
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
175T00000X
Peer Specialist
—
—
Other
Enumeration date
10/16/2017
Last updated
07/09/2024
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