Individual
MELISSA GABRIELA CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1175 E 300 N, PROVO, UT 84606
(801) 852-4510
Mailing address
750 N FREEDOM BLVD, PROVO, UT 84601-1677
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
142671423102
UT
Other
Enumeration date
04/20/2026
Last updated
04/20/2026
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