| NPI | 1568973097 |
|---|---|
| Other Name | MIKE CLEMENT |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60098052) |
| Enumeration Date | 2017-10-24 |
| Last Update Date | 2022-10-18 |