Ethan Clark

NPI #1013717925 in American Fork, Utah

Provider Information

NPI Number: 1013717925
Entity Type: Individual
Name: Ethan Clark
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Behavior Technician
Enumeration Date: Mar 18, 2025
Last Updated: Mar 18, 2025

Practice Location

Address: 1159 E 200 N STE 100
City: American Fork
State: Utah
ZIP Code: 84003-2053
Phone: (801) 935-4171

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Behavior Technician	106S00000X	Primary

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