Individual
REYNOLDS CLODFELTER, JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3141 JOHN HUMPHRIES WYND, RALEIGH, NC 27612-5438
(919) 783-5431
Mailing address
3141 JOHN HUMPHRIES WYND, RALEIGH, NC 27612-5438
(919) 783-5431
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2910
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000762
—
NC
Enumeration date
08/05/2006
Last updated
07/09/2007
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