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1063090264
CLINTON TROY MERRITT
MOLINE, IL
NPI
1063090264
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: IL 178.016552)
Enumeration Date
2021-03-30
Last Update Date
2021-03-30
Business Address
CLINTON TROY MERRITT
4600 3RD ST
MOLINE, IL 61265-6106
Phone number: 708-305-4041
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Mailing Address
CLINTON TROY MERRITT
605 E 6TH ST
COAL VALLEY, IL 61240-9522
Phone number: 708-305-4041
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