Individual
DEANNA MACKAY-CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
9301 SOUTH WIGHTS FORT RD, SUITE 215, WEST JORDAN, UT 84088
(801) 282-2200
(801) 282-2220
Mailing address
PO BOX 711185, SALT LAKE CITY, UT 84171
(801) 942-3311
(801) 942-5955
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1088554201
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
L0295
—
UT
Enumeration date
09/16/2006
Last updated
07/08/2007
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