Individual
EMMALEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
209 W 300 N, LOGAN, UT 84321-3809
(435) 716-8535
Mailing address
1065 S FORGOTTEN LN, PROVIDENCE, UT 84332-9319
(435) 770-5917
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
13444587-4201
UT
Other
Enumeration date
12/11/2020
Last updated
06/16/2023
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