Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 37PC00079900 | NJ |
NPI | 1003014754 |
---|---|
Provider Name | Dr. Susan V. Clayton |
First Address | Toms River, NJ 08753-8328 |
Second Address | Toms River, NJ 08753-8328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2007 |
Last Update Date | 08/07/2007 |