Provider Demographics
NPI:1760293336
Name:CLARKE, CHRISTINE (AUD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:CLARKE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1536 WOODLAND PARK DR STE 220
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-5620
Mailing Address - Country:US
Mailing Address - Phone:801-525-5254
Mailing Address - Fax:801-790-0982
Practice Address - Street 1:1536 WOODLAND PARK DR STE 220
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-5620
Practice Address - Country:US
Practice Address - Phone:801-525-5254
Practice Address - Fax:801-790-0982
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13902067-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist