Provider Demographics
NPI:1497009468
Name:CLAWSON, NOLAN K
Entity Type:Individual
Prefix:
First Name:NOLAN
Middle Name:K
Last Name:CLAWSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 461
Mailing Address - Street 2:
Mailing Address - City:MORONI
Mailing Address - State:UT
Mailing Address - Zip Code:84646
Mailing Address - Country:US
Mailing Address - Phone:435-445-5200
Mailing Address - Fax:435-445-5201
Practice Address - Street 1:22000 N 10380 E
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:UT
Practice Address - Zip Code:84629
Practice Address - Country:US
Practice Address - Phone:435-427-5704
Practice Address - Fax:435-427-5703
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)