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Individual

MRS. KIMBERLY WILLIS CLAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
516 S MARTIN LUTHER KING JR DR, SAINT MARTINVILLE, LA 70582-3102
(337) 427-8710
Mailing address
1137 S BERNARD RD, STE. A PMB#1012, BROUSSARD, LA 70518-3388
(337) 427-8710

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
8749
LA
101Y00000X
Counselor
93013
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1467745000
NPI
LA
Enumeration date
05/18/2016
Last updated
11/15/2023
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