Teryl L Clark, LCSW

NPI #1588097786 in American Fork, Utah

Provider Information

NPI Number: 1588097786
Entity Type: Individual
Name: Teryl L Clark, LCSW
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Credential: LCSW
Enumeration Date: Aug 12, 2013
Last Updated: Aug 12, 2013

Practice Location

Address: 789 BAMBERGER DR
Address 2: SUITE A
City: American Fork
State: Utah
ZIP Code: 84003-2181
Phone: (801) 915-8792

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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