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Individual

MR. WILLIAM CLAY PEARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.S.

Contact information

Practice address
211 W MESA AVE, SUITE #4, GALLUP, NM 87301-6382
(505) 862-9992
(505) 862-9992
Mailing address
PO BOX 3579, GALLUP, NM 87305-3579
(505) 862-9992
(505) 862-9992

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
4206
NM
101YM0800X
Mental Health Counselor
Primary
0088461
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
58475532
NM
Enumeration date
05/08/2007
Last updated
06/03/2016
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