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Individual

CLINTON R GHOLSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
650 SCARBOUROUGH, CANYON LAKE, TX 78133-4529
(830) 964-4390
Mailing address
5447 HAWK EYE DR, BULVERDE, TX 78163-2255
(210) 392-9520

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
77796
TX

Other

Enumeration date
12/26/2018
Last updated
12/26/2018
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