BRENT CLEMENZ

LAFAYETTE, IN
NPI1710003363
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IN  34005245A)
Enumeration Date2007-03-22
Last Update Date2007-07-08
Business Address
-- BRENT CLEMENZ
670 N 36TH ST
LAFAYETTE, IN 47905-4474
Phone number: 765-446-8412
Mailing Address
-- BRENT CLEMENZ
917 KING ST
LAFAYETTE, IN 47905-1821
Phone number: