Individual
ANTIONETTE DENIKA VANCLEAVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 WINSTON WAY STE 3, CAMPBELLSVILLE, KY 42718-4991
(270) 403-0560
Mailing address
102 WINSTON WAY STE 3, CAMPBELLSVILLE, KY 42718-4991
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
255311
KY
Other
Enumeration date
07/15/2021
Last updated
07/15/2021
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