Provider Demographics
NPI:1336224906
Name:BJARNASON, CAROLINE CLARK (MS)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:CLARK
Last Name:BJARNASON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 N 1075 W
Mailing Address - Street 2:SUITE 230
Mailing Address - City:FARMINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84025-2745
Mailing Address - Country:US
Mailing Address - Phone:801-447-9456
Mailing Address - Fax:801-447-9458
Practice Address - Street 1:1401 N 1075 W
Practice Address - Street 2:SUITE 230
Practice Address - City:FARMINGTON
Practice Address - State:UT
Practice Address - Zip Code:84025-2745
Practice Address - Country:US
Practice Address - Phone:801-447-9456
Practice Address - Fax:801-447-9458
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2407231H00000X
CAHA6081237700000X
UT5542067-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist