Provider Demographics
NPI:1528277407
Name:JUAB CO SCHOOL DISTRICT
Entity type:Organization
Organization Name:JUAB CO SCHOOL DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-623-1940
Mailing Address - Street 1:PO BOX 182
Mailing Address - Street 2:346 E 600 N
Mailing Address - City:NEPHI
Mailing Address - State:UT
Mailing Address - Zip Code:84648
Mailing Address - Country:US
Mailing Address - Phone:435-623-1940
Mailing Address - Fax:435-623-1941
Practice Address - Street 1:346 E 600 N
Practice Address - Street 2:
Practice Address - City:NEPHI
Practice Address - State:UT
Practice Address - Zip Code:84648
Practice Address - Country:US
Practice Address - Phone:435-623-1940
Practice Address - Fax:435-623-1941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT62586704102235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty