Provider Demographics
NPI:1346125143
Name:CLARK, ALLISON JOY (RDN, MPP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:JOY
Last Name:CLARK
Suffix:
Gender:F
Credentials:RDN, MPP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:JOY
Other - Last Name:ELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1055 W 1033 N APT 404
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-4906
Mailing Address - Country:US
Mailing Address - Phone:385-335-5907
Mailing Address - Fax:
Practice Address - Street 1:1055 W 1033 N APT 404
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-4906
Practice Address - Country:US
Practice Address - Phone:385-335-5907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14220976-4901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered