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Contact Information

KATHLEEN P CLARK, MA, BCBA, LBA
31 LONE HOLW
SANDY, UT84092-5500
 Phone: 801-647-5254
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Behavior Analyst

103K00000X
 

Developmental Therapist

222Q00000X
Indicates primary specialty

NPI Profile & details for KATHLEEN P CLARK · (Female)

NPI Number 1497098446
Status Active
Credentials MA, BCBA, LBA
Entity Individual
Enumeration date 03/28/2013
Last updated 03/15/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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