Individual
CLINTON TROY MERRITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4600 3RD ST, MOLINE, IL 61265-6106
(708) 305-4041
Mailing address
605 E 6TH ST, COAL VALLEY, IL 61240-9522
(708) 305-4041
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
178.016552
IL
Other
Enumeration date
03/30/2021
Last updated
03/30/2021
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