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Individual
CLIVE RUSSELL HALLAM
Active
Individual
CLIVE RUSSELL HALLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LMFT 134
WY
106H00000X
Marriage & Family Therapist
Primary
0001268
CO
106H00000X
Marriage & Family Therapist
8971102-3902
UT
Other
Enumeration date
05/21/2008
Last updated
01/18/2021
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