Individual
JAMES KENNETH CLEMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS LPC
Contact information
Practice address
2725 NE EUCLID AVE, LAWTON, OK 73507-7147
(580) 704-5575
(580) 585-6436
Mailing address
2725 NE EUCLID AVE, LAWTON, OK 73507-7147
(580) 704-5575
(580) 585-6436
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
425
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100803130 C
—
OK
Enumeration date
01/19/2010
Last updated
01/19/2010
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