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Individual
CLYDE A RICHARDSON
Active
Individual
CLYDE A RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M DIV CAC-R
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
6802067415
MI
101YM0800X
Mental Health Counselor
6802067415
MI
101YP1600X
Pastoral Counselor
6802067415
MI
Other
Enumeration date
05/05/2008
Last updated
06/26/2009
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