Provider Demographics
NPI:1760804207
Name:CLAWSON, ROBB (LMFT)
Entity Type:Individual
Prefix:
First Name:ROBB
Middle Name:
Last Name:CLAWSON
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3651 N 100 E
Mailing Address - Street 2:STE. 300
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-4597
Mailing Address - Country:US
Mailing Address - Phone:801-935-8694
Mailing Address - Fax:
Practice Address - Street 1:3651 N 100 E
Practice Address - Street 2:STE. 300
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-4597
Practice Address - Country:US
Practice Address - Phone:801-935-8694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-18
Last Update Date:2014-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7127255-3902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist