Individual
LEEVI GRANT CLUTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
180 WELLNESS DR, SUMMERSVILLE, WV 26651-5401
(304) 872-0058
(304) 872-0116
Mailing address
180 WELLNESS DR, SUMMERSVILLE, WV 26651-5401
(304) 872-0058
(304) 872-0116
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
175T00000X
Peer Specialist
Primary
26-901MH
WV
Other
Enumeration date
06/04/2025
Last updated
02/03/2026
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