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Individual
KELLY LISABETH CLANTON
Active
Individual
KELLY LISABETH CLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PPC
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PPC-1573
WY
Other
Enumeration date
07/22/2025
Last updated
07/22/2025
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