Clark, Louise
Clark, Louise is an individual health care provider with primary practice located at 345 E 4500 S Ste 260 , Murray UT 84107-3954. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Clark, Louise can be contacted via phone (801) 747-3556.Contact Information
Primary practice address
345 E 4500 S Ste 260
Murray UT 84107-3954
Phone: (801) 747-3556
Fax: (801) 747-2086
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X |
Profile Details
| NPI number | 1124335914 |
|---|---|
| LBN Legal business name | Clark, Louise |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 1st, 2010 |
| Last updated | Sep 1st, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124335914 | NPPES |
| Utah | MEDICAID | 1497071419 |
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