Individual
CLAYTON BACCHUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1315 TAYLOR ST NW, WASHINGTON, DC 20011-5507
(202) 882-5697
Mailing address
1315 TAYLOR ST NW, WASHINGTON, DC 20011-5507
(202) 882-5697
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
PRC14141
DC
Other
Enumeration date
12/16/2012
Last updated
12/16/2012
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