Individual
CLAYTON WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
1108 POPLAR PL, ROGERS, AR 72756-4249
(479) 372-6464
(479) 372-6460
Mailing address
2809 FOREST HOME RD, JONESBORO, AR 72401-5320
(866) 972-1268
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
238703795
—
AR
Enumeration date
09/22/2022
Last updated
09/22/2022
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