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Individual

ADRIAN PAUL MCCLAREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
230 GOODMAN RD E STE 102, SOUTHAVEN, MS 38671-8313
(901) 355-1770
(662) 349-6626
Mailing address
230 GOODMAN RD E STE 102, SOUTHAVEN, MS 38671-8313
(901) 355-1770
(662) 349-6626

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
LMT000999
TN
106H00000X
Marriage & Family Therapist
Primary
T0167
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
204866674
TAX ID
TN
Enumeration date
05/01/2007
Last updated
03/29/2016
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