Individual
KAITLYN CLEVENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
777 S MAIN ST STE 100, CLINTON, IN 47842-2493
(765) 828-1003
Mailing address
7745 N HUNTINGTON ST, TERRE HAUTE, IN 47805-1008
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
88002109A
IN
Other
Enumeration date
11/05/2024
Last updated
11/05/2024
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