Individual
MR. CLIFTON JAMES DEROME
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
1267 W DEER HAVEN DR, PORTLAND, IN 47371-8381
(260) 726-7394
(260) 726-2941
Mailing address
1267 W DEER HAVEN DR, PORTLAND, IN 47371-8381
(260) 726-7394
(260) 726-2941
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22003469A
IN
Other
Enumeration date
05/04/2006
Last updated
07/09/2007
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