Individual
MR. JAYCE DEAN CLARK II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1053 W 1020 S, PROVO, UT 84601-5656
(801) 515-3323
Mailing address
141 S 200 W, AMERICAN FORK, UT 84003-2207
(808) 391-0052
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
14197389-6006
UT
106S00000X
Behavior Technician
—
—
Other
Enumeration date
01/29/2021
Last updated
08/04/2025
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