Individual
MR. CLAYTON DAVID WILSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3250 ZEMKE AVE, TAMPA, FL 33621-5023
(813) 420-3988
Mailing address
3250 ZEMKE AVE, TAMPA, FL 33621-5023
(813) 420-3988
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
069614-1
NY
Other
Enumeration date
12/19/2005
Last updated
09/16/2020
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