Individual
MR. CLAYTON THADDEUS RUDOLF PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
680 STEWART AVE, SAINT PAUL, MN 55102-4117
(763) 957-7677
Mailing address
680 STEWART AVE, SAINT PAUL, MN 55102-4117
(763) 957-7677
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
306742
MN
Other
Enumeration date
04/20/2026
Last updated
04/20/2026
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